血必净联合CBP治疗ICU急性呼吸窘迫综合征疗效及对血气分析、血浆APN的影响

Efficacy of Xuebijing injection combined with CBP in the treatment of acute respiratory distress syndrome in ICU and its effect on blood gas analysis and plasma APN

目的 观察血必净联合连续性血液净化(CBP)治疗重症监护室(ICU)急性呼吸窘迫综合征(ARDS)疗效及对血气分析、血浆脂联素(APN)的影响。方法 选取2016年6月至2017年12月本院ICU收治的ARDS患者84例,随机分为观察组及对照组,各42例。对照组进行基础治疗和CBP治疗,观察组在对照组基础上联合血必净治疗,比较两组治疗1周后疗效。结果 治疗7天后,两组pH值、PaO2、PaO2/FiO2均显著高于治疗前,且观察组pH值、PaO2、PaO2/FiO2改善程度均优于对照组,差异均有统计学意义(均P<0.05);两组血清TXB2、IL-8、ET-1水平均显著低于治疗前,且观察组TXB2、IL-8、ET-1水平改善程度优于对照组,差异均有统计学意义(均P<0.05);两组血浆APN水平均显著高于治疗前,且观察组APN水平改善程度优于对照组,差异有统计学意义(P<0.05);两组ALIS及APACHEⅡ评分均显著低于治疗前,且观察组ALIS及APACHEⅡ评分改善程度均优于对照组,差异有统计学意义(P<0.05)。结论 血必净联合CBP治疗ARDS,可以改善患者血气结果,降低炎性反应,提高血浆APN水平,减轻急性症状和肺损伤程度。

Objective To observe the efficacy of Xuebijing injection combined with continuous blood purification(CBP)in the treatment of acute respiratory distress syndrome(ARDS)in intensive care unit(ICU)and its effect on blood gas analysis and plasma adiponectin(APN).Methods 84 cases of ARDS patients treated in ICU of our hospital from June 2016 to December 2017 were selected and randomly divided into observation group(n=42)and control group(n=42).The control group was given basic treatment and CBP,and the observation group was treated with Xuebijing injection on the basis of the control group.The efficacy was compared between the two groups after 1 week of treatment.Results After 7 d of treatment,the levels of pH,PaO2,and PaO2/FiO2 in the two groups were significantly higher than those before treatment(P<0.05),and the improvement degree in the observation group was more significant than that in the control group(P<0.05);serum levels of TXB2,IL-8,and ET-1 in the two groups were significantly lower than those before treatment(P<0.05),and the improvement degree in the observation group was more significant than that in the control group(P<0.05);the level of plasma APN in the two groups were significantly higher than those before treatment(P<0.05),and the improvement degree in the observation group was more significant than that in the control group(P<0.05);the scores of ALIS and APACHEII in the two groups were significantly lower than those before treatment(P<0.05),and the improvement degree in the observation group was more significant than that in the control group(P<0.05).Conclusion Xuebijing injection combined with CBP for ARDS can improve blood gas results,reduce inflammatory reaction,increase plasma APN level,and relieve acute symptoms and lung injury degree.