血必净联合乌司他丁对脓毒症患者内环境稳态的影响

Effect of Xuebijing combined with ulinastatin on the homeostasis of sepsis patients

目的:探讨血必净联合乌司他丁对脓毒症患者内环境稳态的影响。方法:选择在本院接受治疗的烧伤后脓毒症患者78例纳入研究,回顾性分析治疗方案并分为接受乌司他丁治疗的A组40例、接受血必净联合乌司他丁治疗的B组38例,持续治疗7d后评估疗效。结果:治疗前,两组炎症因子、氧化应激指标、心肌损伤标志物、凝血功能指标水平比较,差异无统计学意义(P>0.05)。治疗后,B组血清中超敏-C反应蛋白(hs-CRP)、白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子α(TNF-α)的含量低于A组;血清中总抗氧化能力(T-AOC)、谷胱甘肽过氧化物酶(GSH-Px)的含量高于A组,脂质过氧化氢(LHP)、晚期蛋白氧化产物(AOPP)的含量低于A组;血清中乳酸脱氢酶(LDH)、肌钙蛋白Ⅰ(cTnⅠ)、B型脑钠肽(BNP)的含量低于A组;外周血凝血酶原时间(PT)、凝血酶时间(TT)、部分凝血活酶时间(APTT)的水平高于A组,纤维蛋白原(FIB)的水平低于A组(P<0.05)。结论:烧伤后脓毒症患者接受血必净联合乌司他丁治疗,可有效减轻机体炎症应激反应并积极保护心肌功能、减轻高凝状态。

Objective: To investigate the effect of Xuebijing combined with ulinastatin on the homeostasis of sepsis patients. Methods: 78 patients with post-burn sepsis who received treatment in our hospital between January 2016 and January 2019 were included in the study.The treatment regimen was retrospectively analyzed and used to divide the patients into the group A ( n =40) receiving ulinastatin treatment and the group B ( n =38) receiving Xuebijing combined with ulinastatin treatment.The efficacy was evaluated after 7 d of continuous treatment. Results: Before the treatment,there were no significant differences in levels of inflammatory factors,oxidative stress indicators,myocardial injury markers or coagulation function indicators between the two groups ( P >0.05).After the treatment,serum high-sensitivity C-reactive protein (hs-CRP),interleukin-6 (IL-6),interleukin-8 (IL-8) and tumor necrosis factor-α(TNF-α) contents in group B were lower than those in group A;serum total antioxidant capacity (T-AOC) and glutathione peroxidase (GSH-Px) contents were higher than those in group A,while lipid hydroperoxide (LHP) and advanced protein oxidation product (AOPP) contents were lower than those in group A;serum lactate dehydrogenase (LDH),troponin I (cTn I) and B-type brain natriuretic peptide (BNP) contents were lower than those in group A;peripheral blood prothrombin time (PT),thrombin time (TT) and partial thromboplastin time (APTT) levels were higher than those in group A,while fibrinogen (FIB) level was lower than that in group A ( P <0.05).Conclusion: Xuebijing combined with ulinastatin can effectively reduce the inflammatory stress response,actively protect the myocardial function and reduce the hypercoagulable state in patients with post-burn sepsis.