银杏达莫注射液对脓毒症患者血清肿瘤坏死因子α、降钙素原、细菌脂多糖及28 d病死率的影响

Effect of Ginkgo leaf extract and dipyridamole injection on serum tumor necrosis factor-α,procalcitonin,bacterial lipopolysaccharide and 28-day mortality in patients with sepsis

目的探讨银杏达莫注射液辅助治疗对脓毒症患者血清肿瘤坏死因子α(TNF-α)、降钙素原(PCT)、细菌脂多糖(LPS)水平及28 d病死率的影响。方法选取2018年2月至2019年2月于宁波市鄞州人民医院就诊的脓毒症患者90例,采用随机数字表法将其分为研究组与对照组,各45例。对照组予以常规治疗,研究组予以银杏达莫注射液和常规治疗。比较两组患者疗效、治疗前后急性生理学与慢性健康状况评价(APACHEⅡ)评分、序贯器官衰竭评分(SOFA评分),血清TNF-α、PCT与LPS水平;比较两组患者28 d病死率。结果研究组总有效率为91.11%(41/45),对照组为75.56%(34/45),两组差异有统计学意义(χ^(2)=6.690,P=0.039);治疗后研究组患者APACHEⅡ评分和SOFA评分均低于对照组[(15.93±1.01)分、(6.25±1.83)分,(18.62±1.75)分、(8.54±2.19)分](t=8.931、5.383,均P<0.001);治疗后研究组患者TNF-α、PCT和LPS水平均低于对照组[(43.62±3.39)ng/L、(1.46±0.79)μg/L、(23.62±7.19)ng/L,(56.28±4.54)ng/L、(2.12±1.03)μg/L、(33.75±8.67)ng/L](t=14.989、3.411、6.033,P<0.001、P=0.001、P<0.001);研究组28 d病死率为6.67%(3/45),对照组为22.22%(10/45),差异有统计学意义(χ^(2)=8.160,P=0.017)。结论在常规治疗的基础上辅以银杏达莫注射液治疗可以改善脓毒症患者临床症状,减轻机体炎性反应,降低病死率。

Objective To investigate the effect of Ginkgo leaf extract and dipyridamole injection on serum tumor necrosis factor-α,procalcitonin,lipopolysaccharide and 28-day mortality in patients with sepsis.Methods Ninety patients with sepsis who received treatment in Ningbo Yinzhou People's Hospital from February 2018 to February 2019 were included in this study.They were randomly assigned to receive routine treatment(control group,n=45)or Ginkgo leaf extract and dipyridamole injection treatment combined with routine treatment(treatment group,n=45).Clinical efficacy,preoperative and postoperative Acute Physiology and Chronic Health Evaluation II score,Sequential Organ Failure Assessment score,serum tumor necrosis factor-α,procalcitonin,bacterial lipopolysaccharide levels as well as 28-day mortality were compared between the control and treatment groups.Results There was significant difference in total effective rate between the treatment and control groups[91.11%(41/45)vs.75.56%(34/45),χ^(2)=6.690,P=0.039].After treatment,Acute Physiology and Chronic Health Evaluation II score and Sequential Organ Failure Assessment score in the treatment group were(15.93±1.01)points and(6.25±1.83)points,respectively,which were significantly lower than those in the control group[(18.62±1.75)points,(8.54±2.19)points,t=8.931,5.383,all P<0.001].After treatment,serum tumor necrosis factor-α,procalcitonin and lipopolysaccharide levels in the treatment group were(43.62±3.39)ng/L,(1.46±0.79)μg/L,(23.62±7.19)ng/L,respectively,which were significantly lower than those in the control group[(56.28±4.54)ng/L,(2.12±1.03)ng/L,(33.75±8.67)ng/L,t=14.989,3.411,6.033,P<0.001,P=0.001,P<0.001].The 28-day mortality in the treatment group was significantly lower than that in the control group[6.67%(3/45)vs.22.22%(10/45),χ^(2)=8.160,P=0.017].Conclusion Based on routine treatment,Ginkgo leaf extract and dipyridamole injection can improve the clinical symptoms of patients with sepsis,reduce inflammatory reaction and decrease mortality.