血必净注射液对危重病患者血浆可溶性髓样细胞表达的触发受体1和乳酸水平及预后的影响

Effects of Xuebijing injection on soluble triggering receptor expressed on myeloid cells-1, serum lactate and prognosis in critical patients

目的 探讨血必净注射液对危重病患者血浆可溶性髓样细胞表达的触发受体1（sTREM-1）、乳酸水平及预后的影响.方法 选择2008年1月至2010年12月江苏省无锡市中医医院重症监护病房收治的危重病患者46例,按照入院先后顺序将所有患者随机分为常规治疗组（22例）和血必净治疗组（24例）.血必净治疗组在入重症监护病房时给予100 ml血必净注射液溶于100 ml 0.9％氯化钠注射液中静脉滴注,2次/d,连续给药7 d.常规治疗组给予常规对症治疗.2组患者均于治疗前及治疗后第7天检测血浆sTREM-1、乳酸水平,并进行急性生理学与慢性健康状况评分Ⅱ（APACHE Ⅱ）,比较2组治疗后28 d内多器官功能障碍综合征（MODS）发生率及病死率.结果 2组治疗前血浆sTREM-1、乳酸水平和APACHE Ⅱ评分比较,差异均无统计学意义（均P＞0.05）.治疗后,血必净治疗组sTREM-1、乳酸水平和APACHE Ⅱ评分均明显低于治疗前和常规治疗组[（50±31） ng/L比（63±27）、（71±38） ng/L,（1.9±1.0） mmol/L比（4.6±1.4）、（2.7±1.3） mmol/L,（12±4）分比（22±4）、（14±5）分],差异均有统计学意义（均P ＜0.05）.血必净治疗组治疗后28 d内MODS发生率和病死率明显低于常规治疗组[33.3％ （8/24）比63.6％ （14/22）、16.7％（4/24）比45.5％（10/22）],差异均有统计学意义（均P＜0.05）.结论 血必净注射液能明显降低危重病患者血浆sTREM-1、乳酸水平,有助于改善预后.

Objective To investigate the effects of Xuebijing injection on soluble triggering receptor expressed on mveloid cells-1 （sTREM-1）,serum lactate and prognosis in critical patients.Methods Forty-six patients admitted to intensive care unit （ICU） from January 2008 to December 2010 were randomly divided into routine therapy group （22 cases） given routine therapy and Xuebijing therapy group （24 cases） administrated with Xuebijing injection （100 ml,twice daily for 7 days）.The sTREM-1 and lactate concentration in serum,the acute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ） scores were determined before and 7 days after treatment;the 28-day mortality and 28-day incidence of multiple organ dysfunction syndrome （MODS） compared between groups.Results Before treatment,the sTREM-1 and lactate in serum,APACHE Ⅱ scores were not significantly different between groups （P 〉 0.05）.After treatment,the sTREM-1 and lactate iu serum,APACHE Ⅱ scores in Xuebijing therapy group were significantly lower than those before treatment and those in routine therapy group [（50±31） ng/Lvs （63±27）,（71±38） ng/L,（1.9±1.0） mmol/Lvs （4.6±1.4）,（2.7±1.3） mmol/L,（12 ±4） scores vs （22 ±4）,（14 ±5） scores] （P 〈0.05）.The 28-day mortality and 28-day incidence of MODS in Xuebijing therapy group were significantly lower than those in routine therapy group [33.3% （8/24） vs 63.6% （14/22）,16.7% （4/24） vs 45.5% （10/22）] （P 〈0.05）.Conclusion Xuebijing injection can significantly reduce the concentrations of serum sTREM-1 and lactate and is helpful for improving clinical outcome in critical patients.