血必净对老年急性脓毒血症休克患者疗效及对BNP及IL-27的影响

Effects of Xuebijing on BNP and IL-27 and Elderly Patients with Acute Septic Shock

目的:探讨血必净治疗老年急性脓毒血症休克患者的临床疗效及其对患者B型脑钠肽(BNP)及白细胞介素-27(IL-27)的影响。方法:将我院收治的96例老年急性脓毒血症休克患者随机分成两组,每组48例。两组患者均给予液体复苏、循环支持、抗感染等常规对症支持治疗,观察组在此基础上联合给予血必净注射液静脉滴注,对照组给予等量5%葡萄糖注射液静脉滴注。比较两组临床疗效、治疗前后血清BNP、IL-27水平变化情况以及治疗前后循环功能及氧代谢指标变化情况。结果:两组患者治疗后血清BNP、IL-27水平均有明显下降(P<0.01),观察组治疗后血清BNP、IL-27水平明显低于对照组(P<0.01)。两组患者治疗后24h、48h、72h时HR、PVR与治疗前相比均有明显下降(P<0.01),CVP、MAP、SVR明显上升(P<0.01),观察组治疗后24h、48h、72h各项循环功能指标改善效果均明显优于对照组同时点(P<0.01)。结论:血必净注射液可有效降低老年急性脓毒血症休克患者的心肌损伤程度,与常规治疗相比疗效更为确切。

Objective: To investigate the clinical efficacy of Xuebijing injection in the treatment of elderly patients with acute septic shock and its influence on tybe B brain natriuretic peptide (BNP) and interleukin-27 (IL-27).Methods: 96 cases of elderly patients with acute septic shock treated in our hospital were selected and randomly divided into two groups,48 cases in each.The two groups of patients were all given fluid resuscitation,circulatory support,anti infection and other conventional symptomatic support therapy,on the basis of which,the observation group was combined with Xuebijing Injection.And the control group was given the same amount of 5% Glucose Injection intravenous infusion.Then the clinical efficacy,the changes of serum BNP,IL-27 levels,as well as the changes in the level of cycling function and the changes in oxygen metabolism indicators of the two groups before and after the treatment were compared.Results: The serum levels of BNP and IL-27 significantly decreased after the treatment in the two groups (P<0.01).The serum levels of BNP and IL-27 in the observation group were significantly lower than those in the control group (P<0.01).After24h,48h and 72h of the treatment HR,and PVR of patients of the two groups significantly decreased compared with those before the treatment (P<0.01) and CVP,MAP,SVR significantly increased (P<0.01).In the observation group,after24h,48h and 72h of the treatment,the improvement effect of the cycle function indexes was significantly better than that of the control group at the same time point (P<0.01).Conclusion: Xuebijing injection can effectively reduce the myocardial injury whose effect is more precise compared with the conventional treatment.