摘要
目的探讨血必净注射液佐治老年重症肺炎(SP)并呼吸衰竭的临床疗效及对炎性因子的影响。方法选择2012年10月至2014年12月上海交通大学医学院附属新华医院收治的126例社区获得性SP患者为研究对象,依据随机数字表法分为研究组(65例)和对照组(61例)。对照组患者采用抗感染、辅助通气、解痉、抗凝等常规治疗,研究组在此基础上联合静脉滴注血必净注射液,每日2次,7 d为1个疗程,连续使用2个疗程。治疗7d后,测定两组患者动脉血气指标与外周血炎性因子水平,判定急性生理和慢性健康评分Ⅱ(APACHEⅡ)与临床疗效。结果治疗后7 d,研究组动脉血氧分压(Pa O2)、氧合指数(Pa O2/Fi O2)显著高于对照组[(86.3±7.4)mm Hg(1 mm Hg=0.133 k Pa)比(82.6±6.3)mm Hg;295±39比276±35],动脉血二氧化碳分压(Pa CO2)显著低于对照组[(44.5±5.1)mm Hg比(46.7±4.3)mm Hg],差异均有统计学意义(P<0.05)。治疗后7 d,研究组肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6、IL-8、高敏C反应蛋白(hs-CRP)数值均显著低于对照组[(78±24)ng/L比(92±28)ng/L;(38±9)ng/L比(42±10)ng/L;(40±10)ng/L比(47±11)ng/L;(38±9)mg/L比(48±12)mg/L],差异均有统计学意义(P<0.05)。治疗后7 d,研究组APACHEⅡ评分显著低于对照组[(14.4±4.0)分比(16.7±4.3)分],差异有统计学意义(P<0.05)。结论 SP患者在常规治疗基础上联合使用血必净注射液能显著改善肺部氧合功能,降低APACHEⅡ评分,下调炎性因子水平,能进一步提高临床疗效。
Objective To observe clinical efficacy of Xuebijing injection in adjuvant treatment of elderly patients with severe pneumonia （SP） and its influence on inflammatory factors. Methods A total of 126 community acquired SP patients admitted to Shanghai Jiaotong University School of Medicine Affiliated Xinhua Hospital from Oct. 2012 to Dec. 2014 were included as study objects, and were randomized into study group（65 cases） and control group（61 cases） according to random number table method. The control group was treated with routine treatment, such as anti-infection, spasmolysis, assisted ventilation, anticoagulation, based on which the study group was added with Xuebijing injection,2 times daily, continued for 14 d,7 d after treatment, arterial blood gas indexes and peripheral blood inflammatory factor were examined, and acute physiologic and chronic health evaluation I1 （ APACHE I1 ） and clinical efficacy were assessed. Results 7 d after treatment,PaO2 ,PaO2/FiO2 of the study group were significandy higher than the control group[ （86. 3 ± 7.4） mmHg vs （82. 6 ± 6. 3 ） mmHg;295±s 39 vs 276 ± 35 ], while PaCO2 was si!!;nifieantly lower than the control group [ （44.5± 5.1 ） mmHg vs （46.7 ±4.3 ） mmHg ], the differences were all statistically signifi- cant（ P 〈 0. 05 ） ; tumor necrosis factor-α （ TNF-α ）, interleukin （IL） -6, IL-8, hypersensitive C-reactive protein （hs-CRP） values of the study group were significantly lower than the control group [ （78 ± 24 ） ng/L vs （92 ±28） ng/L; （38±9） ng/L vs （42 ± 10） ng/L; （40 ± 10） ng/L vs （47 ± 11） ng/L; （38 ± 9） mg/L vs （48± 12 ） mg/L ] , the differences were all statistically significant （P 〈 0.05 ）. The APACHEII score of the study group was significantly lower than control group [ （ 14.4 ±4.0 ） score vs （ 16. 7 ± 4.3 ） score ], the differences was statistically significant （ P 〈 0. 05 ）. Conclusion Based on routine treatment, SP patients combinedly using of Xuebijing injection can significantly improve pulmonary oxygenation function, reduce APACHE Ⅱ score, down-regulate inflammatory factor levels, and further improve the clinical efficacy for SP patients
出处
《医学综述》
2015年第22期4166-4168,共3页
Medical Recapitulate
关键词
重症肺炎
呼吸衰竭
血必净注射液
炎性因子
氧合指数
疗效
Severe pneumonia
Respiratory failure
Xuebijing injection
Inflammatory factor
Oxygen- ation index： Clinical efficacy
