血必净治疗重症胰腺炎的临床疗效及对凝血功能的影响

Xuebijing injection for treatment of severe acute pancreatitis:Clinical efficacy and influence on blood coagulation function

目的探讨血必净注射液治疗重症急性胰腺炎(severe acute pancreatitis,SAP)的疗效及对凝血功能的影响.方法 2012-01/2016-01期间宁波鄞州人民医院急诊科、消化科及重症医学科收治的76例SAP患者按随机数字表分为观察组和对照组,每组各38例.对照组患者接受常规治疗,观察组患者在对照组治疗的基础上接受血必净射液100 m L,2次/d,两组的疗程均为10 d.比较两组患者的比较治疗后血清中白细胞(white blood cell,WBC)、淀粉酶(amylase,AMY)、C-反应蛋白(C reactive protein,CRP)、肿瘤坏死因子-a(tumor necrosis factora,TNF-a)、白介素-6(interleukin,IL-6)及APACHEⅡ评分及临床疗效,同时比较两组患者治疗前后凝血指标.结果观察组患者治疗后血清中WBC、AMY、CRP、TNF-a水平及APACHEⅡ评分均低于对照组(均P<0.05);观察组治疗总有效率高于对照组(94.7%vs 84.2%,P<0.05);观察组患者在治疗后凝血酶原时间、活化部分凝血活酶时间、凝血酶时间及D-二聚体均低于对照组(均P<0.05),观察组患者治疗后血清中PLT增加较对照组明显.结论血必净辅助治疗SAP能较好降低血淀粉酶及炎症因子水平,提高临床疗效,同时可改善患者的凝血功能.

AIM To evaluate the clinical efficacy of Xuebijing injection in the treatment of severe acute pancreatitis（SAP） and its influence on blood coagulation function.METHODS Seventy-six SAP patients treated at our hospital from January 2012 to January 2016 were randomly divided into a control group and an observation group（n = 38 each）.The control group was routinely treated,and the Xuebijing group was additionally treated with Xuebijing injection 100 mL twice a day for 10 d.White blood cell count（WBC）,amylase（AMY）,C-reactive protein（CEP）,tumor necrosis factor-α（TNF-α）,interleukin-6（IL-6）,platelet count（PLT）,prothrombin time（PT）,thrombin time（TT）,fibrinogen（Fib）,activated partial thromboplastin time（APTT）,and D-dimer in the two groups were compared before and after treatment.Acute Physiology and Chronic Health Evaluation Ⅱ（APACHE Ⅱ）score was also compared.RESULTS In the observation group,the levels of WBC,AMY,CRP,TNF-α,IL-6 and APACHE Ⅱ were significantly lower than those of the control group（P 0.05）.The overall efficacy rate of the observation group was significantly higher than that of the control group（94.7%vs 84.2%,P 0.05）.In the observation group,PT,APTT,TT and D-dimer levels were significantly lower than those of the control group,while PLT was significantly higher than that of the control group（P 0.05）.CONCLUSION Xuebijing injection can reduce serum levels of amylase and inflammatory factors and improve blood coagulation function in SAP patients,thereby increasing clinical therapeutic efficacy.