血必净注射液联合低分子肝素对老年急性呼吸窘迫综合征正五聚蛋白3、乙酰肝素酶水平的影响

Effects of Xuebijing Injection combined with low molecular weight heparin on PTX3 and HPSE levels in elderly patients with acute respiratory distress syndrome

目的分析血必净注射液联合低分子肝素对老年急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)患者正五聚蛋白3(pentraxin 3,PTX3)、乙酰肝素酶(heparanase,HPSE)水平的影响。方法收集2019年1月至2021年12月在我院治疗的100例老年ARDS患者进行前瞻性研究,随机将患者分为对照组50例,研究组患者50例,对照组采用低分子肝素治疗,研究组采用低分子肝素、血必净注射液治疗,检测两组血气指标、凝血指标、炎症因子、PTX3、HPSE、临床指标水平,对比两组临床疗效。结果与治疗前相比,治疗后动脉血氧分压(arterial partial pressure of oxygen,PaO_(2))、二氧化碳分压(partial pressure of carbon dioxide,PCO_(2))、氧合指数(PaO_(2)/FiO_(2))、纤维蛋白原(fibrinogen,FBI)、血小板计数(platelet count,PLT)表达升高,凝血酶原时间(Prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、肿瘤坏死因子⁃α(tumor necrosis factor⁃α,TNF⁃α)、白细胞介素⁃6(interleukin⁃6,IL⁃6)、白细胞介素⁃10(interleukin⁃10,IL⁃10)、PTX3、HPSE表达水平降低,且研究组变化幅度较大(P<0.05)。研究组患者APACHEⅡ评分、机械通气时间、ICU住院时间低于对照组,治疗有效率高于对照组(P<0.05)。结论血必净注射液、低分子肝素联合治疗可降低老年ARDS患者PTX3、HPSE,改善患者凝血功能,治疗效果较好。

Objective To analyze the effects of Xuebijing injection combined with low molecular weight heparin on PTX3 and HPSE levels in elderly ARDS patients.Methods A total of 100 elderly patients with ARDS hospitalized in our hospital from January 2019 to December 2021 were engaged in the prospective study.They were randomly divided into control group(n=50)and research group(n=50);the former group treated with low mo⁃lecular weight heparin and the latter with Xuebijing Injection combined with low molecular weight heparin.The two groups were compared in terms of blood gas indexes,coagulation indexes,inflammatory factors,PTX3,HPSE,clinical indexes,and the clinical efficacy.Results Compared with pre⁃treatment,the levels of PaO_(2),PCO_(2),PaO_(2)/FiO_(2),FBI,and PLT expression were increased,and the levels of PT,APTT,TNF⁃α,IL⁃6,IL⁃10,PTX3,and HPSE expression were decreased in both groups,but the changes in the levels of all the indexes in the study group were statistically significant as compared with those in the control group(P<0.05).Besides,the APACHEⅡscore was significantly lower,the mechanical ventilation time and ICU hospitalization time were both significantly shorter,and the treatment was significantly more efficient,compared with the control group(P<0.05).Conclusion Xuebijing injection combined with low molecular weight heparin has a good therapeutic effect for elderly ARDS patients,for it can reduce PTX3 and HPSE and improve their coagulation function.