血必净注射液联合去甲肾上腺素对感染性休克患者血流动力学、血清炎症因子和免疫功能的影响

Effects of Xuebijing Injection combined with Norepinephrine on hemody-namics,serum inflammatory factors,and immune function in patients with septic

目的探究血必净注射液联合去甲肾上腺素对感染性休克患者血流动力学、血清炎症因子和免疫功能的影响。方法选取2022年10月至2023年9月浙江省金华市人民医院重症医学科就诊的98例感染性休克患者作为研究对象。按照随机数字表法将其分为对照组和观察组,每组49例。对照组采用去甲肾上腺素治疗,观察组采用血必净注射液联合去甲肾上腺素治疗,疗程为2周。比较两组治疗前后血流动力学指标[中心静脉压(CVP)、平均动脉压(MAP)、心脏指数(CI)、混合静脉血氧饱和度(SvO_(2))、脉搏血氧饱和度(SpO_(2))]、血清炎症因子指标[白细胞介素(IL)-6、IL-8、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、B型脑钠肽(BNP)]、免疫功能指标[CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、自然杀伤(NK)细胞]水平。结果治疗后,两组CVP、MAP、CI、SvO_(2)、SpO_(2)水平高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。治疗后,两组IL-6、IL-8、PCT、TNF-α、BNP水平低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于治疗前,NK细胞水平低于治疗前,且观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组,NK细胞水平低于对照组,差异有统计学意义(P<0.05)。结论血必净联合去甲肾上腺素能够更好地改善感染性休克患者的血流动力学反应,减少炎症机制,提高免疫力,值得推广。

Objective To investigate the effects of Xuebijing Injection combined with Norepinephrine on hemodynamics,serum inflammatory factors,and immune function in patients with septic shock.Methods A total of 98 septic shock patients from October 2022 to September 2023 in the Department of Intensive Care Medicine,Jinhua People’s Hospital of Zhejiang Province were selected as the study objects.They were divided into control group and observation group according to random number table method,with 49 cases in each group.The control group was treated with Norepinephrine,and observation group was treated with Xuebijing Injection combined with Norepinephrine,the course of treatment was two weeks.The levels of hemodynamic indexes(central venous pressure[CVP],mean arterial pressure[MAP],cardiac index[CI],mixed venous oxygen saturation[SvO_(2)],pulse oxygen saturation[SpO_(2)]),serum inflammatory factors indexes(interleukin[IL]-6,IL-8,procalcitonin[PCT],tumor necrosis factor-α[TNF-α],B-type brain natriuretic peptide[BNP]),and immune function indexes(CD3^(+),CD4^(+),CD4^(+)/CD8^(+),natural killer[NK]cell)were compared between two groups before and after treatment.Results After treatment,the levels of CVP,MAP,CI,SvO_(2),and SpO_(2)in both groups were higher than before treatment,and those of observation group were higher than those of control group,and the differences were statistically significant(P<0.05).After treatment,the levels of IL-6,IL-8,PCT,TNF-α,and BNP in two groups were lower than before treatment,and those of observation group were lower than those of control group,and the differences were statistically significant(P<0.05).After treatment,the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8+in two groups were higher than before treatment,and the level of NK cell was lower than before treatment,and the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in observation group were higher than those in control group,and the level of NK cell was lower than that in control group,and the differences were statistically significant(P<0.05).Conclusion Xuebijing Injection combined with Norepinephrine can better improve the hemodynamic response of patients with septic shock,reduce the inflammatory mechanism,and improve immunity,which is worth promoting.