参麦注射液联合乌司他丁对重症脓毒症患者微循环功能的影响

Effect of Shenmai injection combined with ulinastatin on microcirculation of severe sepsis patients

目的探讨参麦注射液联合乌司他丁对重症脓毒症患者微循环功能的影响。方法选取中南大学湘雅三医院2013年6月—2014年8月收治的重症脓毒症患者120例,随机分为治疗组和对照组,各60例。治疗组采用参麦注射液联合乌司他丁治疗,对照组采用常规治疗。观察治疗后两组患者的舌下微循环指标〔流动指数(MFI)、总血管密度(TVD)、灌注血管密度(PVD)、灌注血管比例(PPV)〕,住院时间、病死率、急性生理学与慢性健康状况Ⅱ(APACHEⅡ)评分等。结果 MFI、TVD、PVD、PPV治疗方法与时间有交互作用,差异有统计学意义(P<0.05),时间间比较,差异有统计学意义(P<0.05),组间比较,差异有统计学意义(P<0.05)。两组治疗24h、48h、72h的MFI、TVD、PVD、PPV比较,差异有统计学意义(P<0.05);治疗组住院时间短于对照组,APACHEⅡ评分和病死率低于对照组,差异有统计学意义(P<0.05)。结论麦参注射液联合乌司他丁可以有效改善重症脓毒症患者微循环,增加组织灌注,降低病死率,改善患者预后。

Objective To investigate the effect of Shenmai injection combined with ulinastatin on microcirculation of severe sepsis patients. Methods A total of 120 patients with severe sepsis in the Third Xiangya Hospital of Central South Uni-versity from June 2013 to August 2014 were selected,they were randomly divided into treatment group and control group,60 ca-ses in each group. The treatment group was treated with Shenmai injection combined with ulinastatin,control group was treated with conventional therapy. In the two groups,the index of tongue microcirculation,including flow index（MFI）,total vascular density（TVD）,blood vessel density（PVD）,blood vessel density（PPV）score were observed,and the length of hospital stay,mortality,acute physiology and chronic health status（APACHE Ⅱ）score were observed. Results MFI,TVD,PVD, PPV treatments had interaction with time,the differences were statistically significant（P 〈 0. 05）,comparison between time, the differences were statistically significant（P 〈 0. 05）,comparison among group,the differences were statistically significant （P 〈 0. 05）. MFI,TVD,PVD,PPV at 24h,48h,72h between the two groups showed significant differences（P 〈 0. 05）, length of hospital stay of treatment group was shorter than control group,APACHE Ⅱ score and mortality were lower than control group,the differences were statistically significant（P 〈 0. 05）. Conclusion Shenmai injection combined with ulinastatin can effectively improve the microcirculation in the treatment of severe sepsis,increased tissue perfusion and reduce the mortality, improve the prognosis of the patients.