血必净注射液联合乌司他丁注射液治疗脓毒症并发急性肺损伤的效果及对HMGB1/TLR4/NF-κB信号通路的影响

Effect of Xuebijing Injection Combined with Ulinastatin Injection in the Treatment of Sepsis Complicated with Acute Lung Injury and Its Effect on HMGB1/TLR4/NF-κB Signaling Pathway

目的 探讨血必净注射液联合乌司他丁注射液治疗脓毒症合并急性肺损伤的临床效果及对高迁移率族蛋白B1(HMGB1)/Toll样受体4(TLR4)/核因子-κB(NF-κB)信号通路的影响。方法 采用随机数字表法将2022年1—12月接受治疗的140例脓毒症并发急性肺损伤患者分为研究组70例和对照组70例。2组均按指南给予基础治疗,在此基础上研究组给予血必净注射液联合乌司他丁注射液治疗,对照组给予血必净注射液治疗,2组疗程均为2周。比较2组临床疗效,治疗前后血清HMGB1、TLR4及NF-κB水平,血清炎性因子水平,并记录2组不良反应。结果 治疗后研究组总有效率为91.43%(64/70)优于对照组的75.71%(53/70)(P<0.05)。治疗后2组血清HMGB1、TLR4、NF-κB、超敏C反应蛋白、肿瘤坏死因子-α、降钙素原水平均降低,且研究组低于对照组(P<0.05,P<0.01)。2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论 血必净注射液联合乌司他丁注射液治疗脓毒症并发急性肺损伤患者临床效果较好,可有效降低血清HMGB1、TLR4、NF-κB和炎性因子水平,且安全性较高。

Objective To investigate the clinical effect of Xuebijing injection combined with Ulinastatin injection in the treatment of sepsis complicated with acute lung injury and their effect on high mobility group protein B1(HMGB1)/Toll-like receptor 4(TLR4)/nuclear factor-κB(NF-κB)signaling pathway.Methods In total,140 patients with sepsis complicated with acute lung injury who received treatment from January to December 2022 were divided into research group(n=70)and control group(n=70)by random number table method.Both groups received basic treatment according to the guidelines.On this basis,the research group was treated with Xuebijing injection combined with Ulinastatin injection,and the control group was treated with Xuebijing injection.The course of treatment in both groups was 2 weeks.The clinical efficacy,serum HMGB1,TLR4 and NF-κB levels,levels of serum inflammatory factors before and after treatment were compared between the two groups,and adverse reactions were recorded in the two groups.Results After treatment,the total effective rate of the research group was 91.43%(64/70),which was better than that of the control group(75.71%)(53/70)(P<0.05).After treatment,serum levels of HMGB1,TLR4,NF-κB,hypersensitive C reactive protein,tumor necrosis factor-αand procalcitonin in the two groups were decreased,which were lower in the research group than in the control group(P<0.05,P<0.01).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Xuebijing injection combined with Ulinastatin injection has good clinical effect in the treatment of patients with sepsis complicated with acute lung injury,which can effectively reduce the levels of serum HMGB1,TLR4,NF-κB and inflammatory factors,with high safety.