血必净注射液对EICU脓毒症患者炎症应激反应和心肌功能的影响

Effect of Xuebijing injection on inflammatory stress response and myocardial function in patients with sepsis of EICU

目的:探讨血必净注射液治疗急诊重症监护室(EICU)脓毒症患者的疗效,以及对机体炎症应激反应和心肌功能的影响。方法:采用随机数字表法将190例脓毒症分为常规组和血必净组,每组均95例。两组均严格按照脓毒症治疗指南(2016年版)给予常规抗脓毒症集束化治疗,血必净组在常规治疗基础上给予血必净注射液治疗,常规组给予等量的0.9%氯化钠注射液。观察两组治疗前和治疗7 d后急性和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分,检测并比较治疗前后血清炎性因子肿瘤坏死因子-α(TNF-α)、超敏C-反应蛋白(hs-CRP)、降钙素原(PCT)、白介素-6(IL-6)和心肌损伤标志物血肌钙蛋白I(cTn I)、肌酸激酶同工酶(CK-MB)水平,统计两组EICU住院时间和28 d死亡率。结果:两组治疗7 d后血清TNF-α、hs-CRP、PCT、IL-6和cTn I、CK-MB水平均明显下降(P<0.05),且治疗组治疗7 d后上述炎性因子和心肌功能指标水平显著低于常规组,差异有统计学意义(P<0.05)。治疗组治疗7 d后APACHEⅡ评分明显低于常规组,EICU住院时间较常规组明显缩短,差异有统计学意义(P<0.05),两组28 d病死率比较差异无统计学意义(P>0.05)。结论:常规对症治疗联合血必净注射液能有效减轻脓毒症患者机体炎症应激反应和保护心肌功能,对改善病情程度和缩短EICU住院时间有一定价值。

Objective:To investigate the therapeutic effect of Xuebijing injection on sepsis patients in emergency intensive care unit(EICU),and its effect on inflammatory stress response and myocardial function.Methods:190 cases of sepsis were divided into routine group and Xuebijing group with 95 cases in each group.Both groups were treated with routine anti sepsis cluster therapy in strict accordance with the sepsis treatment guidelines(2016 version).Xuebijing group was treated with Xuebijing injection on the basis of routine treatment,and the routine group was treated with 0.9%sodium chloride injection.The scores of acute and chronic health status scoring systemⅡ(APACHEⅡ)were observed before and 7 days after treatment in the two groups.The levels of serum inflammatory factors,tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs CRP),procalcitonin(PCT),interleukin-6(IL-6),cardiac injury markers,serum cardiac troponin I(cTnI),creatine kinase isoenzyme(CK-MB)were measured and compared before and after treatment in the two groups hospital time and 28 day mortality.Results:The levels of TNF-α,hs CRP,PCT,IL-6,cTnI and CK-MB in the two groups decreased significantly after 7 days of treatment(P<0.05),After 7 days of treatment,the levels of inflammatory factors and myocardial function indexes in the treatment group were significantly lower than those in the control group(P<0.05).After 7 days of treatment,APACHEⅡscore in the treatment group was significantly lower than that in the conventional group,EICU hospitalization time was significantly shorter than that in the conventional group,the difference was statistically significant(P<0.05),and there was no statistically significant difference in 28 day mortality between the two groups(P>0.05).Conclusion:the routine symptomatic treatment combined with Xuebijing injection can effectively reduce the inflammatory stress response and protect the myocardial function of sepsis patients,and has significant value in improving the degree of illness and shortening the length of EICU hospitalization.