血必净注射液对重症中暑合并DIC患者的临床疗效及其对PT、ALT、Cr水平的影响

To investigate the clinical efficacy of Xuebijing injection in patients with severe heat stroke complicated with DIC and its influence on PT,ALT and Cr levels

目的分析血必净注射液对重症中暑合并弥散性血管内凝血(DIC)患者的临床疗效及其对凝血酶原时间(PT)、丙氨酸氨基转移酶(ALT)、肌酐(Cr)水平的影响。方法选取2018年7月至2019年10月在该院急诊病区治疗的68例重症中暑合并DIC患者作为研究对象,采用随机数字表法将其分为基础组和血必净组,每组34例。基础组采用基础退热、解痉挛等治疗,血必净组在基础组治疗的基础上采用国产药物血必净注射液治疗,观察两组患者的临床疗效,以及凝血、血小板、肾功能、血清酶及血管内皮损伤指标等水平。结果血必净组患者临床总有效率为97.06%,高于基础组的85.29%(P<0.05)。两组患者治疗前PT、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)水平、血小板计数(PLT)比较,差异均无统计学意义(P>0.05);血必净组患者治疗后FIB水平、PLT均高于治疗前,且血必净组均高于基础组,PT、APTT均短于治疗前,且血必净组均短于基础组(P<0.05)。两组患者治疗前肌酸激酶(CK)、天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、ALT水平比较,差异均无统计学意义(P>0.05);两组患者治疗后CK、AST、LDH、ALT水平均低于治疗前,且血必净组均低于基础组(P<0.05)。两组患者治疗前Cr、尿素氮(BUN)水平比较,差异均无统计学意义(P>0.05);两组患者治疗后Cr、BUN水平均低于治疗前,且血必净组均低于基础组(P<0.05)。两组患者治疗前血管假性血友病因子(vWF)、凝血酶调节蛋白(TM)水平比较,差异均无统计学意义(P>0.05);两组患者治疗后vWF、TM水平均低于治疗前,且血必净组均低于基础组(P<0.05)。结论血必净注射液治疗重症中暑合并DIC患者,能够通过改善其凝血功能,增强其肾功能,减少内皮损伤而提高临床疗效。

Objective To analyze the clinical efficacy of Xuebijing injection on patients with severe heat stroke complicated with disseminated intravascular coagulation(DIC)and its influence on prothrombin time(PT),alanine aminotransferase(ALT)and creatinine(Cr)levels.Methods A total of 68 patients with severe heat stroke complicated with DIC admitted to the emergency ward of this hospital from July 2018 to October 2019 were selected as the research objects.They were divided into basic group and Xuebijing group by random number table method,with 34 cases in each group.The basic group was treated with basic antipyretic and antispasmodic treatment,and the Xuebijing group was treated with domestic drug Xuebijing injection on the basis treatment of the basic group.The clinical efficacy,coagulation,platelet,renal function,serum enzymes and vascular endothelial injury indicators of the two groups were observed.Results The total effective rate of Xuebijing group was 97.06%,which was higher than 85.29%of the basic group(P<0.05).There was no statistically significant difference in the PT,activated partial thromboplastin time(APTT),fibrinogen(FIB)level and platelet count(PLT)between the two groups before treatment(P>0.05).After treatment,the levels of FIB level and PLT in the Xuebijing group were higher than those before treatment,and those in the Xuebijing group were higher than those in the basic group,and the PT and APTT were shorter than those before treatment,and those in the Xuebijing group were shoeter than those in the basic group(P<0.05).There was no statistically significant differences in the levels of creatine kinase(CK),aspartate aminotransferase(AST),lactate dehydrogenase(LDH)and ALT between the two groups before treatment(P>0.05).The levels of CK,AST,LDH,and ALT in the two groups after treatment were lower than those before treatment,and those in the Xuebijing group were lower than those in the basic group(P<0.05).There was no significant differences in Cr and blood urea nitrogen(BUN)levels between the two groups before treatment(P>0.05).The levels of Cr and BUN in the two groups after treatment were lower than those before treatment,and those in the Xuebijing group were lower than those in the basic group(P<0.05).There was no statistically significant difference in the levels of von Willebrand factor(vWF)and thrombomodulin(TM)between the two groups before treatment(P>0.05).After treatment,the levels of vWF and TM in the two groups were lower than those before treatment,and those in the Xuebijing group were lower than those in the basic treatment group(P<0.05).Conclusion Xuebijing injection can improve the clinical efficacy of severe heat stroke complicated with DIC patients by improving coagulation function,enhancing renal function and reducing endothelial injury.