血必净注射液对脓毒症患者血浆组蛋白H4的影响及意义

Effects and clinical value of Xuebijing Injection on plasma histone H4 in patients with sepsis

[目的]观察血必净注射液对脓毒症患者血浆组蛋白H4的影响及意义。[方法]对2017年7月-2018年6月天津医科大学总医院急诊医学科收治的60例脓毒症患者,随机分为对照组和治疗组。检测患者入院时、24及72 h时血浆组蛋白H4、D-二聚体和白介素-6(IL-6)水平。收集患者性别、年龄、急性生理与慢性健康评分(APACHEⅡ)及序贯器官衰竭评估评分(SOFA),随访28 d生存状态。[结果]与对照组相比,治疗组患者24 h时血浆组蛋白H4、D-二聚体和IL-6显著降低(P<0.01)。72 h时两组间D-二聚体和IL-6水平无统计学差异(P>0.05)。与对照组相比,治疗组72 h时的APACHEⅡ及SOFA分值有统计学差异(P<0.01)。死亡患者入院时EH4水平显著高于存活者(P<0.01)。[结论]血必净注射液可能通过降低脓毒症患者血浆组蛋白H4,纠正凝血功能紊乱和过度炎症反应,改善病情严重程度。

[Objective] The aim of this study was to observe the effect and clinical value of Xuebijing(XBJ) Injection on plasma histone H4 in patients with sepsis.[Methods] Sixty septic patients admitted to the department of emergency medicine,Tianjin Medical University General Hospital from July 2017 to June 2018,were randomly assigned into the control group(n=30) and intervention group(n =30). Plasma was collected at 0,24 and 72 hrs on admission. The gender,age,APACHE II and SOFA scores and 28-day mortality between the two groups were collected.[Results] Compared with the control group,plasma histone H4,D-dimer and IL-6 levels were significantly reduced at 24 hrs in the intervention group(P<0.01). There was no significant difference in plasma D-dimer and IL-6 levels between the two groups at 72 hrs(P >0.05). Compared with the control group,the APACHE II and SOFA scores at 72 hrs in the intervention group were statistically reduced(P<0.01). Plasma histone H4 levels were associated with 28-day mortality on admission(P<0.01).[Conclusion] XBJ injection may correct coagulopathy and inflammatory response,and improve the severity of the disease via reducing histone H4 in septic patients.