血必净注射液对脓毒症患者治疗效果及血清甲状腺激素水平的影响

Clinical Effects of Xuebijing Injection in Treating Sepsis and Its Impacts on the Levels of Serum Thyroid Hormone

目的:分析血必净注射液对脓毒症患者治疗效果及血清甲状腺激素水平的影响。方法:将90例患者随机分为观察组和对照组,每组45例。对照组采用常规治疗,观察组在此基础上加用血必净注射液治疗。比较两组患者治疗前后外周血炎性因子水平,急性生理与慢性健康评分Ⅱ(APACHE-Ⅱ)、序贯器官衰竭评分(SOFA)评分,甲状腺激素(T_3、T_4、FT_3、FT_4、PCT)水平及28天内死亡率。结果:经过治疗后,两组各时间点TNF-α、IL-6水平均低于治疗前,差异具有统计学意义(P<0.05)。治疗第7、14天时,观察组肿瘤坏死因子α(tumor necrosis factorα,TNF-α)、白细胞介素6(interleukin-6,IL-6)水平分别低于同时期对照组患者,差异有统计学意义(P<0.05)。经过治疗后,两组各时间点APACHE-Ⅱ、SOFA评分均低于治疗前,差异有统计学意义(P<0.05)。治疗第7、14天时,观察组APACHE-Ⅱ、SOFA评分分别低于同时期对照组,差异有统计学意义(P<0.05)。经过治疗后,两组T3、T4、FT3水平均高于治疗前,PCT水平低于治疗前,差异具有统计学意义(P<0.05)。观察组T3、T4、FT3水平均高于对照组,PCT水平低于对照组,差异具有统计学意义(P<0.05)。对照组28天死亡率为28.89%(13/45)高于观察组的11.11%(5/45),差异有统计学意义(P<0.05)。结论:血必净可能通过有效降低脓毒症患者TNF-α、IL-6水平,抑制了正常甲状腺病态综合征状态的发展,从而降低患者的APACHE-Ⅱ、SOFA评分和死亡率。

Objective:To analyze clinical effects of Xuebijing injection in the treatment of sepsis and its influence on the levels of serum thryoid hormone.Methods:All 90 patients were randomized into two groups,45 cases each group.The control group adopted conventional therapy,and the observation group took Xuebijing injection based on conventional therapy.To compare the levels of TNF-αand IL-6 before and after treating between different groups,the scores of APACHE-Ⅱand SOFA,the levels of thyroid hormone(T3,T4,FT3 and PCT)and mortality rate within 28 days.Results:After treating,the levels of TNF-αand IL-6 in different groups at different time points were lower than these before treating,and the difference showed statistical meaning(P<0.05).The levels of TNF-αand IL-6 in the observation group were lower than these of the control group at the same period respectively seven and 14 days after treating,and the difference was statistically significant(P<0.05).After treating,the scores of APACHE-Ⅱand SOFA of both groups at different times were lower than these before treating,and the difference was statistically significant(P<0.05).The scores of APACHE-Ⅱand SOFA of the observation group were lower than these of the control group in the same period seven and 14 days after treating,and the difference showed statistical meaning(P<0.05).After treating,the levels of T3,T4 and FT3 in different groups were higher than these before treating,the level of PCT lower than that before treating,and the difference showed statistical meaning(P<0.05).The observation group was higher than the control group in the levels of T3,T4 and FT3,lower than the control group in PCT levels,and the difference was statistically significant(P<0.05).Mortality rate within 28 days of the control group was 28.89%(13/45),higher than 11.11%(5/45)of the observation group,and the difference demonstrated statistical meaning(P<0.05).Conclusion:Xuebijing coud reduce the scores of APACHE-Ⅱand SOFA,the mortality rate of sepsis patients through effectively reducing the levels of TNF-αand IL-6,and inhibiting the development of ESS state.