血必净注射液改善急性肝衰竭患者凝血功能临床分析

Analysis of Xuebijing Injection in Improvement of Blood Coagulation of Patients with Acute Liver Failure

目的探究血必净注射液对各种病因致急性肝衰竭患者改善凝血功能的作用。方法选取我院2013年6月—2015年4月收治的128例各种病因致急性肝衰竭患者,随机分为对照组和研究组。对照组64例,采用常规综合治疗;研究组64例,在常规综合治疗基础上加用血必净注射液。治疗7 d后,检测两组治疗前后的凝血酶原时间(prothrombin time,PT)、部分凝血酶原时间(partial prothrombin time,APTT)、纤维蛋白原(fibrinogen,FIB)、凝血酶原活动度(prothrombin activity,PTA)、D-二聚体(D dimer,D-D)、血小板(platelet,PLT)计数,以及进行终末期肝病模型(the model for end-stage liver disease,MELD)评分。同时把两组各20例弥漫性血管内凝血(disseminated intravascular coagulation,DIC)患者治疗后血凝指标进行比较(其中研究组20例为A组,对照组20例为B组)。结果研究组MELD评分明显低于对照组(P<0.01);凝血功能指标变化:治疗后对照组和研究组PT、APTT、FIB、PTA、D-D、PLT计数均较治疗前得到改善(P<0.01),其中研究组中各指标均显著优于对照组(P<0.01)。治疗后A组和B组血凝指标优于治疗前,A组血凝指标亦显著优于B组(P<0.01)。结论急性肝衰竭患者常规治疗联合应用血必净注射液,能够有效改善凝血功能,延缓DIC的进程。

Objective To investigate the effect of Xuebijing injection in improvement of blood coagulation function of patients with acute liver failure induced by various causes. Methods A total of 128 patients with acute liver failure induced by various causes during June 2013 and April 2015 were randomly divided into control group（ n = 64） and research group（ n =64）. The control group underwent the conventionally comprehensive treatment,while the research group was added with Xuebijing injection therapy based on the conventionally comprehensive treatment. After treatment for 7 d,the values of prothrombin time（ PT）,activated partial thromboplastin time（ APTT）,fibrinogen（ FIB）,prothrombin activity（ PTA）,D dimer（ DD）,platelet（ PLT） count and the model for end-stage liver disease（ MELD） score were detected before and after the treatment in the two groups. The blood coagulation indexes of 20 patients with disseminated intravascular coagulation（ DIC） in each group were detected and compared in the two groups simultaneously. The 20 DIC patients in research group was as group A,and the 20 DIC patients in control group was as group B. Results MELD score in the research group was significantly lower than that in the control group（ P〈0. 01）. The changes of blood coagulation indexes such as PT,APTT,FIB,PTA,D-D and PLT count after treatment in the two groups were significantly improved compared with those before treatment（ P〈0. 01）,and the indexes improvement in research group was superior to that in the control group（ P〈0. 01）. The blood coagulation index values after the treatment were superior to those before the treatment in the two groups,and the values in group A were superior to those in group B（ P〈0. 01）. Conclusion The comprehensive treatment combined with Xuebijing injection in treatment of patients with acute liver failure can effectively improve blood coagulation function and postpone the DIC process.