摘要
目的探讨丹红注射液联合肝素治疗脓毒症并发急性肾损伤的临床疗效及对血清高迁移率族蛋白B1(high mobility group box 1,HMGB1)和可溶性髓样细胞触发受体-1(soluble triggering receptor expressed on myeloid cells-1,sTREM-1)水平的影响。方法选取收治的80例脓毒症并发急性肾损伤患者作为研究对象,用随机数字表法分为2组,每组40例,2组均予以常规治疗,对照组加用低分子肝素,观察组加用低分子肝素和丹红注射液。对比2组的治疗效果,记录2组治疗前后的血清HMGB1、sTREM-1、肾功能指标及凝血功能指标等的变化。结果与治疗前比较,2组治疗后的各项生命指标、炎症指标、凝血功能指标、肾功能指标、HMGB1及sTREM-1水平均得到明显改善(P<0.05)。与对照组比较,观察组治疗后的体温、心率及急性生理学及慢性健康状况评分系统Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)评分均明显更低,血清白细胞介素-6(interleutin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、C反应蛋白(C-reactive protein,CRP)、降钙素原(procall⁃citonin,PCT)、血肌酐(screatinine,Scr)、胱抑素C(cystatin C,CysC)、尿素氮(blood urea nitrogen,BUN)、纤维蛋白原(fibrinogen,FIB)及D-二聚体(D-dimer,D-D)的水平均更低,机械通气时间及ICU住院时间明显更短,凝血酶原时间(prothrombin time,PT)明显更长(P<0.05)。2组治疗后的存活率比较差异无统计学意义(P>0.05)。结论丹红注射液联合肝素治疗能够通过抑制sTREM-1、HMGB1的表达,减轻炎症反应,改善凝血功能,增大肾灌注,减轻肾组织损伤,从而治疗脓毒症并发急性肾损伤。
Objective To investigate the clinical efficacy of Danhong Injections combined with heparin in the treatment of sepsis complicated with acute renal injury and its effect on the levels of serum high mobility group box 1(HMGB1)and soluble triggering receptor expressed on myeloid cells-1(sTREM-1).Methods 80 patients with sepsis complicated with acute renal injury were randomly divided into 2 groups(n=40).The both groups were given the same routine treatment.The control group was added with low molecular weight heparin,and the observation group was added with low molecular weight heparin and Danhong Injections.The therapeutic effects of the 2 groups were compared,and the changes of serum HMGB1,sTREM-1,renal function and coagulation function were recorded before and after treatment.Results Compared with before treatment,the vital indexes,inflammatory indexes,coagulation function indexes,renal function indexes,HMGB1 and sTREM-1 levels in the 2 groups were significantly improved after treatment(P<0.05).Compared with the control group,the body temperature,heart rate and acute physiology and chronic health evaluationⅡ(APACHEⅡ)scores of the observation group after treatment were significantly lower,and the serum interleutin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),procallcitonin(PCT),screatinine(Scr),cystatin C(CysC),blood urea nitrogen(BUN),fibrinogen(FIB),and D-dimer(D-D)levels were lower,mechanical ventilation time and ICU stay were significantly shorter,and prothrombin time(PT)were significantly longer(P<0.05).There was no significant difference in the survival rate between the 2 groups(P>0.05).Conclusion Danhong Injections combined with heparin in the treatment of sepsis complicated with acute renal injury can reduce renal tissue injury by inhibiting the expression of sTREM-1 and HMGB1,reducing inflammatory reaction,improving coagulation function and increasing renal perfusion.
作者
李爱林
袁鼎山
包玉华
蒋海燕
LI Ailin;YUAN Dingshan;BAO Yuhua;JIANG Haiyan(Department of Emergency,Nantong University Affiliated Hospital,Nantong 226001,China;Department of General Medicine,Nantong University Affiliated Hospital,Nantong 226001,China)
出处
《西北药学杂志》
2024年第1期111-115,共5页
Northwest Pharmaceutical Journal
基金
国家自然科学基金项目(编号:81801893)。
关键词
丹红注射液
急性肾损伤
肝素
脓毒症
可溶性髓样细胞触发受体-1
Danhong Injections
acute renal injury
heparin
sepsis
soluble triggering receptor expressed on myeloid cells-1
