血必净注射液对脓毒症患者血清miR-223及高迁移率族蛋白B1表达的影响

Therapeutic effect of Xuebijing injection on serum miR-223 and high mobility group protein B1 expression in patients with sepsis

目的观察血必净注射液对脓毒症患者血清微小RNA-223 (miR-223)及高迁移率族蛋白B1(HMGB1)表达的影响。方法选择2016年4月—2018年9月广东省中医院急诊科收治的脓毒症患者60例作为研究对象,随机数字表法分为接受常规治疗的对照组、接受血必净联合常规治疗的观察组,每组均30例。治疗前及治疗后3 d时,比较急性生理学和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、感染相关脏器功能衰竭评估(SOFA)评分及血清miR-223表达量及HMGB1、炎性介质含量。结果治疗后3 d时,观察组患者APACHEⅡ评分、SOFA评分、白细胞(WBC)计数及血清miR-223表达量、HMGB1含量、C反应蛋白(CRP)、降钙素原(PCT)、内毒素的含量均明显低于对照组(t/P=3.875/0.000、9.558/0.000、6.558/0.000、10.067/0.000、10.832/0.000、5.534/0.000、16.258/0.000、12.568/0.000);miR-223表达量与CRP、PCT、内毒素、APACHEⅡ评分、SOFA评分、WBC均呈正相关(r/P=0.328/0.007、0.263/0.013、0.214/0.019、0.255/0.015、0.352/0.005、0.394/0.002),HMGB1含量与CRP、PCT、内毒素、APACHEⅡ评分、SOFA评分、WBC均呈正相关(r/P=0.294/0.011、0.375/0.004、0.198/0.028、0.177/0.032、0.247/0.016、0.331/0.008)。结论血必净注射液治疗脓毒症能够通过miR-223/HMGB1途径来改善病情、减轻炎性反应。

Objective To observe the effect of Xuebijing injection on the expression of serum microRNA-223(miR-223)and high mobility group protein B1(HMGB1)in sepsis patients.Methods Sixty patients with sepsis admitted to the Emergency Department of Guangdong Traditional Chinese Medicine Hospital from April 2016 to September 2018 were selected as the study subjects.They were randomly divided into control group receiving routine treatment and observation group receiving Xuebijing injection combined with routine treatment,with 30 cases in each group.Before and 3 days after treatment,the acute physiology and chronic health scoreⅡ(APACHEⅡ),infection-related organ failure assessment(SOFA)score,serum miR-223 expression,HMGB1 and inflammatory mediators were compared.Results At 3 days after treatment,the APACHEⅡscore,SOFA score,white blood cell(WBC)count,serum miR-223 expression,HMGB1 content,C-reactive protein(CRP),procalcitonin(PCT),and endotoxin levels were observed in the observation group.Significantly lower than the control group(t/P=3.875/0.000,t/P=9.558/0.000,t/P=6.558/0.000,t/P=10.067/0.000,t/P=10.832/0.000,t/P=5.534/0.000,t/P=16.258/0.000,t/P=12.568/0.000);miR223 expression was positively correlated with CRP,PCT,endotoxin,APACHEⅡscore,SOFA score,WBC(r/P=0.328/0.007).r/P=0.263/0.013,r/P=0.214/0.019,r/P=0.255/0.015,r/P=0.352/0.005,r/P=0.394/0.002),HMGB1 content and CRP,PCT,internal Toxin,APACHE II score,SOFA score,WBC were positively correlated(r/P=0.294/0.011,r/P=0.375/0.004,r/P=0.198/0.028,r/P=0.177/0.032,r/P=0.247/0.016,r/P=0.331/0.008).Conclusion The Xuebijing injection for the treatment of sepsis can improve the condition and reduce the inflammatory response through the miR-223/HMGB1 pathway.