血必净注射液联合持续血液净化治疗重症脓毒症的效果及对血清IL-6、TNF-α的影响

The Curative Effect of Xuebijing Injection Combined With Continuous Blood Purification on Severe Sepsis and Its Influence on Serum IL-6 and TNF-α

目的:研究血必净注射液联合持续血液净化治疗重症脓毒症的效果及对血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的影响。方法:将2012年1月至2013年12月我院收治124例重症脓毒症患者随机分为治疗组和对照组,每组62例。对照组给予常规抗感染、对症支持、脏器保护治疗,治疗组在此基础上加用血必净注射液联合持续血液净化治疗。于治疗前及治疗第7天记录并比较两组患者多器官功能障碍(MODS)发生率、脓毒症休克率、死亡率、好转率、氧合指数(动脉血氧分压(Pa O2)/吸入氧浓度(Fi O2))、血清IL-6、TNF-α水平以及急性生理和慢性健康评分Ⅱ(APACHEⅡ)。结果:经7天治疗后,两组MODS发生率、IL-6、TNF-α水平以及APACHEⅡ评分较治疗前均显著降低,Pa O2/Fi O2水平较治疗前显著提高(均P<0.05);治疗组脓毒症休克率较治疗前显著降低(P<0.05);治疗组MODS发生率、脓毒症休克率、死亡率、IL-6、TNF-α水平以及APACHEⅡ评分均显著低于对照组,好转率以及Pa O2/Fi O2水平显著高于对照组(均P<0.05)。结论:血必净注射液联合持续血液净化治疗重症脓毒症能维护多器官功能、降低MODS及脓毒症休克发生率,提高动脉血气氧合指数等疗效。

Objective： To research the curative effect of Xuebijing injection combined with continuous blood purification on severe sepsis and its influence on the level of serum IL-6 and TNF-α. Methods： 124 patients with severe sepsis who were treated in our hospital from January 2012 to December 2013 were randomly divided into treatment group and control group, each group had 62 cases.The patients in control group were treated with traditional medicine such as antibiotics, symptomatic and supporting medicine, and medicine for organ protection, the patients in treatment group were given Xuebijing injection combined with continuous blood purification therapy besides traditional medicine. The incidence of MODS, septic shock rate, mortality, improvement rate,and levels of Pa O2 or Fi O2, serum IL-6, TNF-α and the APACHE Ⅱscore of the two groups before treatment and after 7 days of therapy were recorded and compared. Results： After 7 days of therapy,the incidence of MODS, the levels of serum IL-6, TNF-αand APACHEⅡ score in both groups decreased, Pa O2/Fi O2 levels significantly increased compared with before treatmeat（P〈0.05）; Septic shock rate of treatment group significantly decreased compared with before treatment（P〈0.05）; The incidence of MODS, septic shock rate, mortality, serum IL-6,TNF-α levels and APACHEⅡ score of treatment group were significantly lower than those of the control group, improvement rate and Pa O2/ Fi O2 levels was higher than those of the control group（P〈0.05）. Conclusion： Xuebijing injection combined with continuous blood purification can maintain multiple organ function, reduce the incidence of MODS and septic shock,and improve arterial blood gas oxygenation index in treating severe sepsis.