血必净注射液联合注射用人免疫球蛋白在重症新型冠状病毒肺炎中的应用价值

Application Value of Xuebijing Combined with Gamma Globulin in Corona Virus Disease 2019

目的 探讨血必净注射液联合注射用人免疫球蛋白治疗重症新型冠状病毒肺炎的临床疗效。方法 采用回顾性研究方法,分析2020年1—3月在支援武汉市新洲区人民医院期间其重症加强护理病房(ICU)和感染内科抗击新型冠状病毒肺炎期间收治的119例重症新型冠状病毒肺炎患者的临床资料。根据治疗方案不同将患者分为对照组87例与观察组32例。对照组给予常规治疗+血必净注射液,观察组给予常规治疗+血必净注射液联合注射用人免疫球蛋白。比较两组患者治疗前后血常规、感染、器官功能相关指标,危重程度评分。结果 两组患者性别、年龄、发病时间比较差异无统计学意义(P>0.05);对照组和观察组治疗前与治疗7 d后中性粒细胞绝对值、红细胞计数、单核细胞绝对值、白细胞计数、同型半胱氨酸、淋巴细胞绝对值、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)评分、序贯器官衰竭评分(SOFA)和降钙素原(PCT)比较差异无统计学意义(P>0.05);对照组和观察组治疗7 d后血细胞比容和血红蛋白降低但差异无统计学意义(P>0.05)。两组患者治疗7 d后丙氨酸转氨酶、碱性磷酸酶、乳酸脱氢酶、血小板计数水平显著升高(P<0.05),尿酸显著降低(P<0.05);观察组患者治疗7 d后白蛋白、总胆固醇和胆碱酯酶较治疗前显著降低(P<0.05);治疗7 d后对照组患者C反应蛋白降低(P<0.05),而观察组C反应蛋白升高(P<0.05);治疗7d后组间比较结果显示,丙氨酸转氨酶与尿酸观察组较对照组显著降低而乳酸脱氢酶上升,差异均有统计学意义(P<0.05)。结论 血必净注射液联合注射用人免疫球蛋白较单独使用血必净注射液可以改善重症新型冠状病毒肺炎患者部分血常规、感染相关指标,器官功能相关指标和危重程度评分,对患者病情起到一定缓解作用。

Objective To evaluate the clinical efficacy of Xuebijing combined with gamma globulin in the treatment of severe Corona Virus Disease 2019.Methods A retrospective research method was used to analyze the support in the ICU and the Department of Infection,People’s Hospital of Wuhan Xinzhou District Hospital of Traditional Chinese Medicine in 2020 Clinical data of 119 patients with Corona Virus Disease 2019 admitted to the Xinzhou District Hospital of Traditional Chinese Medicine during the fight against new coronary pneumonia.The patients were divided into control group(87 cases) and observation group(32cases) according to different treatment schemes.The control group was given conventional treatment + Xuebijing injection,and the observation group was given conventional treatment + Xuebijing injection combined with gamma globulin.The indexes of blood routine,infection,organ function and critical degree score were compared between the two groups before and after treatment.Results There was no significant difference in sex,age and onset time between the two groups(P>0.05);There was no significant difference in neutrophil absolute value,erythrocyte count,monocyte absolute value,leukocyte count,homocysteine,lymphocyte absolute value,acute physiology and chronic health status score Ⅱ(APACHE Ⅱ),sequential organ failure score(sofa) and procalcitonin(PCT) between the control group and the observation group before treatment and 7 days after treatment(P>0.05);The hematocrit and hemoglobin of the control group and the observation group decreased after 7 days of treatment,but the difference was not statistically significant(P>0.05).After 7 days of treatment,the levels of alanine aminotransferase,alkaline phosphatase,lactate dehydrogenase and platelet count increased significantly(P<0.05),and uric acid decreased significantly(P<0.05);After 7days of treatment,albumin,total cholesterol and cholinesterase in the observation group were significantly lower than those before treatment(P<0.05);After treatment,C-reactive protein decreased in the control group(P<0.05),but increased in the observation group(P<0.05);After 7 days of treatment,the results of comparison between the groups showed that the levels of alanine aminotransferase and uric acid in the observation group were significantly lower than those in the control group,while the levels of lactate dehydrogenase were significantly higher(P<0.05).Conclusion Compared with hembijing injection alone,Xuebijing injection combined with human immunoglobulin for injection can improve some blood routine,infection and organ function and critical degree scores of Corona Virus Disease 2019 patients,which plays a certain role in alleviating the patients’ conditions.