血必净注射液对重型新型冠状病毒肺炎患者炎症指标及病情转归的疗效观察

Effect of Xuebijing injection on inflammatory markers and disease outcome of coronavirus disease 2019

目的观察血必净注射液对新型冠状病毒肺炎(简称新冠肺炎)患者炎症指标及预后的影响。方法选择2020年1月至3月长沙市公共卫生救治中心(长沙市第一医院北院)收治的60例重型新冠肺炎患者作为研究对象,按随机数字表法分为常规治疗组、血必净50 mL组和血必净100 mL组,每组20例。常规治疗组依据国家卫生健康委员会(卫健委)发布的新冠肺炎诊疗方案进行治疗;血必净50 mL组在常规治疗基础上加用血必净注射液每次50 mL、每日2次、连用7 d;血必净100 mL组在常规治疗基础上加用血必净注射液每次100 mL、每日2次、连用7 d。观察3组患者治疗前及治疗8 d后血常规、C-反应蛋白(CRP)、红细胞沉降率(ESR)、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)、2019新型冠状病毒(2019-nCoV)核酸检测结果及疾病分型的变化。结果①治疗后,3组白细胞计数(WBC)及淋巴细胞计数(LYM)均较治疗前升高,CRP及ESR均较治疗前降低。与常规治疗组比较,血必净100 mL组治疗后WBC明显升高(×10^9/L:7.12±0.55比5.67±0.51,P<0.05),血必净50 mL组和100 mL组治疗后CRP及ESR明显降低〔CRP(mg/L):32.3±4.6、28.0±6.2比37.3±5.9,ESR(mm/1 h):45.9±5.7、40.5±7.4比55.3±6.6,均P<0.05〕。与血必净50 mL组比较,血必净100 mL组治疗后WBC升高及CRP、ESR下降更明显〔WBC(×10^9/L):7.12±0.55比5.82±0.49,CRP(mg/L):28.0±6.2比32.3±4.6,ESR(mm/1 h):40.5±7.4比45.9±5.7,均P<0.05〕。②治疗后,3组患者APACHEⅡ评分均较治疗前降低;血必净100 mL组治疗后APACHEⅡ评分明显低于常规治疗组和血必净50 mL组(分:12.3±1.5比16.5±1.6、15.9±1.4,均P<0.05)。治疗后,3组2019-nCoV核酸检测均有部分转阴,其中常规治疗组9例、血必净50 mL组8例、血必净100 mL组9例,3组间比较差异无统计学意义(P>0.05)。3组患者治疗后病情均有所改善,其中常规治疗组8例转为普通型、1例转为危重型,血必净50 mL组9例转为普通型,血必净100 mL组12例转为普通型;血必净100 mL组较50 mL组和常规治疗组改善更明显(均P<0.05)。结论血必净注射液可有效改善重型新冠肺炎患者的炎症指标及病情转归。

Objective To observe the influence of Xuebijing injection on the inflammatory markers and prognosis of coronavirus disease 2019(COVID-19)patients.Methods Sixty severe COVID-19 patients admitted to Changsha Public Health Treatment Center(North Hospital of the First Hospital of Changsha City)from January to March in 2020 were randomly divided into routine treatment group,Xuebijing 50 mL group and Xuebijing 100 mL group,with 20 cases in each group.The routine treatment group was treated according to the National Health Commission's guide for COVID-19.On the basis of conventional treatment,Xuebijing injection was injected by 50 mL twice a day for 7 days in Xuebijing 50 mL group,while by 100 mL twice a day for 7 days in Xuebijing 100 mL group.The blood routine test,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,2019 novel coronavirus(2019-nCoV)nucleic acid test and disease classification of three groups before and 8 days after treatment were observed.Results①After treatment,the white blood cell count(WBC)and lymphocyte count(LYM)of three groups increased,meanwhile CRP and ESR decreased.Compared with routine treatment group,the WBC count of Xuebijing 100 mL group after treatment significantly increased(×10^9/L:7.12±0.55 vs.5.67±0.51,P<0.05),and the levels of CRP and ESR in Xuebijing 50 mL and 100 mL groups significantly decreased[CRP(mg/L):32.3±4.6,28.0±6.2 vs.37.3±5.9;ESR(mm/1 h):45.9±5.7,40.5±7.4 vs.55.3±6.6,all P<0.05].Compared with Xuebijing 50 mL group,the increase of WBC,and the decrease of CRP and ESR were more significant in Xuebijing 100 mL group[WBC(×10^9/L):7.12±0.55 vs.5.82±0.49,CRP(mg/L):28.0±6.2 vs.32.3±4.6,ESR(mm/1 h):40.5±7.4 vs.45.9±5.7,all P<0.05].②After treatment,the APACHEⅡscore of three groups decreased.In Xuebijing 100 mL group,the APACHEⅡscore after treatment was significantly lower than those in routine treatment and Xuebijing 50 mL groups(12.3±1.5 vs.16.5±1.6,15.9±1.4,both P<0.05).After treatment,the 2019-nCoV nucleic acid test in three groups partly turned negative,with 9 cases in routine treatment group,8 cases in Xuebijing 50 mL group and 9 cases in Xuebijing 100 mL group,without significant difference(P>0.05).The conditions of patients in the three groups were improved after treatment,among them,8 cases in the routine treatment group were transformed into common type,1 case into critical type;9 cases and 12 cases of Xuebijing 50 mL group and 100 mL group were transformed into common type respectively.Xuebijing 100 mL group was improved more obviously than Xuebijing 50 mL group and routine treatment group(both P<0.05).Conclusion The Xuebijing injection can effectively improve the inflammatory markers and prognosis of severe COVID-19 patients.