血必净注射液改善心肌梗死患者经皮冠状动脉介入治疗后肺部感染的疗效研究

Effect of Xuebijing injection on treatment of pulmonary infection in myocardial infarction patients after percutaneous coronary intervention

目的探讨血必净注射液改善心肌梗死(AMI)患者经皮冠状动脉介入术后(PCI)肺部感染的疗效及对血清白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α、超敏C-反应蛋白(hs-CRP)水平的影响。方法选择本院收治AMI接受急诊PCI后合并肺部感染患者68例,参照随机数字表法分为对照组39例和观察组39例。两组患者在入院后均接受急诊PCI。对照组术后第3d予常规抗菌药物干预。观察组在对照组基础上于术后第3d予血必净注射液,2次/d。两组连续治疗2周。比较两组临床症状消失时间、血白细胞(WBC)计数及临床肺部感染评分(CPIS)。采取流式细胞仪(美国BectonDickinson公司,BD FACSAriaTM II)测定两组T淋巴细胞亚群CD_3^+CD_4^+、CD_3^+CD_8^+变化。检测两组血清IL-6、TNF-α、hs-CRP水平。结果观察组患者的体温恢复正常、咳嗽、肺部啰音消失时间明显短于对照组(P<0.01)。治疗后,观察组患者血WBC计数和CPIS评分显著低于对照组(P<0.01)。观察组治疗后CD_3^+CD_4^+明显高于对照组,CD_3^+CD_8^+明显低于对照组(P<0.01)。治疗后,观察组患者血清IL-6、TNF-α、hs-CRP水平明显低于对照组(P<0.01)。结论在常规抗菌药物基础上,血必净注射液可明显改善心肌梗死AMI患者PCI术后肺部感染,增强患者免疫力及降低炎性反应可能是其疗效途径之一。

OBJECTIVE To explore the effect of Xuebijing injection on treatment of postoperative pulmonary infection in acute myocardial infarction（AMI）patients undergoing percutaneous coronary intervention（PCI）and observe its impact on the levels of serum interleukin（IL）,tumor necrosis factor（TNF）-αand high-sensitivity C-reactive protein（hs-CRP）.METHODS A total of 68AMI patients who received PCI in the hospital were enrolled in the study and randomly divided into the control group with 39cases and the observation group with 39cases.All of the patients received emergency PCI after the admission to hospital.The control group was treated with conventional antibiotics for intervention on the third day after the surgery,while the observation group was given additional Xuebijing injection on bas is of treatment of the control group on the third day after the surgery,and both group were treated for 2consecutive weeks.The time of disappearance of clinical symptoms,white blood cell（WBC）counts and clinical pulmonary infection score（CPIS）were observed and compared between the two group of patients;the levels of T lymphocyte subsets CD3＋CD4＋and CD3＋CD8＋of the two groups of patients were determined by using flow cytometry,and the levels of serum IL-6,TNF-αand hs-CRP were detected.RESULTS The time of recovery of body temperature,time of cough and time of disappearance of pulmonary rales were significantly shorter in the observation group than in the control group（P〈0.01）.The WBC counts and CPIS of the observation group were significantly lower than those of the control group after the treatment（P〈0.01）.The CD3＋CD4＋level of the observation group was significantly higher than that of the control group after the treatment,while the CD3＋CD8＋level of the observation group was significantly lower than that of the control group（P〈0.01）.The levels of serum IL-6,TNF-αand hs-CRP of the observation group were significantly lower than those of the control group（P〈0.01）.CONCLUSIONS On basis of the conventional antibiotics,Xuebijing injection may remarkably improve the postoperative pulmonary infection in the AMI patients undergoing PCI,boost the immunity and reduce the inflammatory reactions.