血必净注射液对严重脓毒症患者凝血功能的干预作用

Intervention effect of Xuebijing injection on coagulation function of patients with severe sepsis

目的观察血必净注射液对脓毒症患者凝血功能的影响。方法选择2015年2月至2017年6月昆明市中医医院急诊科和重症加强治疗病房（ICU）收治的62例严重脓毒症患者，按随机数字表法将患者分为血必净组和常规治疗对照组，每组31例。两组均给予对症支持治疗，血必净组在常规治疗基础上加用血必净注射液50mL静脉滴注、每日2次，连用7d。比较两组治疗前后血小板计数（PLT）和凝血五项D-二聚体、纤维蛋白原（Fib）、活化部分凝血活酶时间（APTT）、凝血酶原时间（PT）、凝血酶时间（TT）以及急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分的差异。结果两组治疗后PLT、Fib均较治疗前明显升高，D-二聚体、APACHEⅡ评分均较治疗前明显降低，APTT、PT、TT较治疗前明显缩短，且以血必净组的变化更显著【PLT（×10^9／L）：186．63±45．29比119．96±59．76，Fib（g/L）：3．88±1．82比2．33±1．33，D-二聚体（mg／L）：0．40±0．11比0．65±0．14，APTT（s）：30．95±8．48比42．25±7．73，PT（S）：10．97±1．51比13．16±2．22，TT（s）：16．17±1．28比18．98±1．12，APACHEⅡ评分（分）：6．62±2．91比12．87±4．54，均P〈0．05]。结论血必净能纠正严重脓毒症患者凝血功能紊乱，改善患者病情，阻止疾病的发展恶化，从而改善患者预后。

Objective To observe the effect of Xuebijing on coagulation function in patients with sepsis. Methods Sixty-two patients with severe sepsis were admitted to Department of Emergency and Intensive Care Unit （ICU） of Kunming Municipal Hospital of Traditional Chinese Medicine from February 2015 to June 2017, and they were divided into Xuebijing group and routine treatment control group according to the random number table method, 31 cases in each group. Both groups were treated with symptomatic supportive therapy, and the Xuebijing group was treated with Xnebijing injection 50 mL intravenous drip on the basis of routine treatment, twice a day for consecutive 7 days. The differences in platelet count （PLT）, 5 items of coagulation： D-dimer, fibrinogen （Fib）, activated partial thromboplastin time （AFFF）, prothrombin time （PT）, thrombin time （TT） and acute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ ） score were compared between the two groups before and after treatment. Results After treatment, in both groups, the levels of PLT and Fib were significantly higher than those before treatment, the level of D-dimer, APACHE Ⅱ were obviously lower than those before treatment, APTT, PT and TT were significantly shorter than those before treatment, and the changes in Xuebijing group were more marked than those in the routine treatment control group [PLT （× 10^9/L）： 186.63±45.29 vs. 119.96±59.76, Fib （g/L）： 3.88± 1.82 vs. 2.33± 1.33, D-dimer （mg/L）： 0.40±0.11 vs. 0.65±0.14, APTT （s）： 30.95±8.48 vs. 42.25±7.73, PT （s）： 10.97±1.51 vs. 13.16＋2.22, TT （s）： 16.17± 1.28 vs. 18.98± 1.12, APACHE Ⅱ score： 6.62±2.91 vs. 12.87±4.54, all P 〈 0.05]. Conclusion Xuebijing can regulate coagulation disorder in patients with severe sepsis, ameliorate the disease condition of patients, block the deterioration of disease development, and improve the prognosis of patients.