血必净在治疗重症肺炎中的临床疗效研究进展
|
摘要
目的研究血必净在治疗重症肺炎中的临床疗效研究进展。方法本研究纳入对象为我院治疗的74例重症肺炎患者,按入院顺序随机均分为观察组与对照组,对照组给予第三代抗生素、营养对症支持等常规治疗,观察组在此基础上联合血必净治疗。连续治疗12d后评价综合临床疗效,比较两组治疗前后血气指标以及血清炎性因子水平,脱机成功率。检测血清免疫球蛋白水平并观察影像学改变。结果观察组治疗7d、12d总有效率分别为75.68%、86.49%,对照组分别为54.05%、72.93%,观察组均显著高于对照组,(P<0.05),均无严重不良反应出现;两组治疗后血清IgM、IgG、IgA水平均显著增加,且治疗后观察组显著高于对照组,(P<0.05);两组治疗前后血气分析各项指标均显著改善,且治疗后观察组均优于对照组,差异具(P<0.05);两组治疗后血清降钙素(PCT)、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)、白细胞介素6(IL-6)水平均显著降低,治疗后观察组显著低于对照组,(P<0.05);治疗后脱机率明显高于对照组。观察组7d、12d呼吸机脱机率分别为69.23%,96.15%,均显著高于对照组的48.28%、82.76%,(P<0.05)。结论联合血必净治疗能降低患者的炎性因子水平,改善重症肺炎患者血气分析指标,提高脱机率。
Objective To study the clinical progress of Xuebijing in treatment of severe pneumonia. Methods 74 patients with severe pneumonia who were treated in our hospital were randomly divided into the observation group and the control group according to the order of admission. The control group was given third-generation antibiotics and nutritional symptomatic support, and the observation group was combined with Xuebijing based on this. After 12 days of continuous treatment, the comprehensive clinical efficacy was evaluated. The levels of blood gas index and serum inflammatory factors and the the success rate of offline were compared before and after treatment, and serum immunoglobulin level was measured and imaging changes were observed. Results The total effective rate of the observation group was 75.68% and 86.49% at 7 d and 12 d, respectively, and 54.05% and 72.93% in the control group, respectively(P<0.05), and there was no serious adverse reactions occurred. The levels of serum IgM, IgG, and IgA were significantly increased after treatment in both groups, and the observation group was significantly higher than the control group after treatment(P<0.05). The blood gas analysis indexes were significantly improved before and after treatment, and the improvement was more pronounced in the observation group than in the control group(P<0.05). The levels of serum calcitonin(PCT), tumor necrosis factor alpha(TNF-α), C-reactive protein(CRP), and interleukin-6(IL-6) after treatment decreased significantly in the two groups, and it was more pronounced in the observation group than in the control group after treatment(P<0.05). The successful offline rate after treatment was significantly higher in the observation group than in the control group. The ventilator off-line rate of the observation group at 7 d and 12 d were 69.23% and 96.15%, respectively, which were significantly higher than those of the control group(48.28%, 82.76%, P<0.05). Conclusion The combination of Xuebijing treatment can reduce the level of inflammatory factors, improve blood gas analysis indicators and offline rate in patients with severe pneumonia.
Objective To study the clinical progress of Xuebijing in treatment of severe pneumonia. Methods 74 patients with severe pneumonia who were treated in our hospital were randomly divided into the observation group and the control group according to the order of admission. The control group was given third-generation antibiotics and nutritional symptomatic support, and the observation group was combined with Xuebijing based on this. After 12 days of continuous treatment, the comprehensive clinical efficacy was evaluated. The levels of blood gas index and serum inflammatory factors and the the success rate of offline were compared before and after treatment, and serum immunoglobulin level was measured and imaging changes were observed. Results The total effective rate of the observation group was 75.68% and 86.49% at 7 d and 12 d, respectively, and 54.05% and 72.93% in the control group, respectively(P<0.05), and there was no serious adverse reactions occurred. The levels of serum IgM, IgG, and IgA were significantly increased after treatment in both groups, and the observation group was significantly higher than the control group after treatment(P<0.05). The blood gas analysis indexes were significantly improved before and after treatment, and the improvement was more pronounced in the observation group than in the control group(P<0.05). The levels of serum calcitonin(PCT), tumor necrosis factor alpha(TNF-α), C-reactive protein(CRP), and interleukin-6(IL-6) after treatment decreased significantly in the two groups, and it was more pronounced in the observation group than in the control group after treatment(P<0.05). The successful offline rate after treatment was significantly higher in the observation group than in the control group. The ventilator off-line rate of the observation group at 7 d and 12 d were 69.23% and 96.15%, respectively, which were significantly higher than those of the control group(48.28%, 82.76%, P<0.05). Conclusion The combination of Xuebijing treatment can reduce the level of inflammatory factors, improve blood gas analysis indicators and offline rate in patients with severe pneumonia.
引文
[1] 郭霞,喻昌利,安庆丽,等.老年重症肺炎患者病原学分布及预后危险因素分析[J].广东医学,2016,37(6):873-875.
[2] ZILBERBERG M D,NATHANSON B H,SULHAM K,et al.Multidrug resistance,inappropriate empiric therapy,and hospital mortality in Acinetobacter baumannii pneumonia and sepsis[J].Crit Care,2016,20(1):221.
[3] 刁云锋,张士俊,赵万勇,等.血必净注射液对重症肺炎患者血浆IL-6和TNF-α水平的影响[J].中草药,2017,48(6):1188-1191.
[4] 白冰,宋宏伟,刘志.CURB-65改良评分评估脓毒症预后的研究[J].中国医科大学学报,2017,46(8):734-738.
[5] 中国医师协会急诊医师分会.中国急诊重症肺炎临床实践专家共识[S].中国急救医学,2016,36(2):97-107.
[6] 郝娜,张建波,高冰洁,等.Braden量表评分联合急性生理学与慢性健康状况评分系统Ⅱ评分预测压疮发生的价值[J].中国全科医学,2016,19(24):2994-2997.
[7] 周曙俊,王瑰,叶吉如.盐酸氨溴索联合血必净治疗老年重症肺炎患者的临床研究[J].中国中西医结合急救杂志,2017,24(5):492-496.
[8] SIMPSON S Q.New sepsis criteria:a change we should not make[J].Chest,2016,149(5):1117-1118.
[9] RHODES A,EVANS L E,ALHAZZANI W,et al.Surviving Sepsis Campaign:international guidelines for management of sepsis and septic shock:2016[J].Crit Care Med,2017,45(3):486-552.
[10] 杨霞,李香琴,马晓媛,等.脓毒症血管内皮损伤及调节策略的研究进展[J].中国中西医结合急救杂志,2016,23(1):108-110.
[11] CIESIELCZUK H,PHEE L M,DOLPHIN H,et al.Optimal detection of carbapenemase-producing Enterobacteriaceae from rectal samples:a role for enrichment?[J].J Hosp Infect,2018,98(3):270-274.
[12] 薄晓霞,刘丽菲,刘颖,等.替加环素联合舒巴坦及法罗培南治疗耐药性老年呼吸机相关性肺炎疗效观察[J].中华实用诊断与治疗杂志,2017,31(2):172-173.
[13] 向贇,汪在华,蔡萍,等.根据β-内酰胺酶选择抗生素对降低细菌性重症肺炎患儿抗生素相关性腹泻发生率的作用[J].中国当代儿科杂志,2016,18(10):1001-1004.
[14] 林秀娟,唐纪文,钟丽红,等.血必净注射液对脓毒症患者凝血功能及预后的影响[J].中国药房,2016,27(5):653-654.
[15] SAMARA P,MIRIAGOU V,ZACHARIADIS M,et al.A fragment of the alarmin prothymosin α as a novel biomarker in murine models of bacteria-induced sepsis[J].Oncotarget,2017,8(30):48635-48649.
[16] 周建.血必净注射液对老年肺感染患者T细胞免疫功能的影响[J].中国中医药科技,2016,23(6):708-709.
[17] CANTIN A M,HANRAHAN J W.Thymosin α1:a single drug with multiple targets in cystic fibrosis[J].Nat Med,2017,23(5):536-538.
[18] 姚兰,刘亚男,侯果,等.血必净注射液在重症肺炎中对机体免疫功能的调控研究[J].湖北中医药大学学报,2017,19(5):35-38.
[19] 陈山.血必净注射液对重症肺炎病人的疗效及其对细胞免疫及炎性因子的影响[J].安徽医药,2017,21(1):127-129.
[2] ZILBERBERG M D,NATHANSON B H,SULHAM K,et al.Multidrug resistance,inappropriate empiric therapy,and hospital mortality in Acinetobacter baumannii pneumonia and sepsis[J].Crit Care,2016,20(1):221.
[3] 刁云锋,张士俊,赵万勇,等.血必净注射液对重症肺炎患者血浆IL-6和TNF-α水平的影响[J].中草药,2017,48(6):1188-1191.
[4] 白冰,宋宏伟,刘志.CURB-65改良评分评估脓毒症预后的研究[J].中国医科大学学报,2017,46(8):734-738.
[5] 中国医师协会急诊医师分会.中国急诊重症肺炎临床实践专家共识[S].中国急救医学,2016,36(2):97-107.
[6] 郝娜,张建波,高冰洁,等.Braden量表评分联合急性生理学与慢性健康状况评分系统Ⅱ评分预测压疮发生的价值[J].中国全科医学,2016,19(24):2994-2997.
[7] 周曙俊,王瑰,叶吉如.盐酸氨溴索联合血必净治疗老年重症肺炎患者的临床研究[J].中国中西医结合急救杂志,2017,24(5):492-496.
[8] SIMPSON S Q.New sepsis criteria:a change we should not make[J].Chest,2016,149(5):1117-1118.
[9] RHODES A,EVANS L E,ALHAZZANI W,et al.Surviving Sepsis Campaign:international guidelines for management of sepsis and septic shock:2016[J].Crit Care Med,2017,45(3):486-552.
[10] 杨霞,李香琴,马晓媛,等.脓毒症血管内皮损伤及调节策略的研究进展[J].中国中西医结合急救杂志,2016,23(1):108-110.
[11] CIESIELCZUK H,PHEE L M,DOLPHIN H,et al.Optimal detection of carbapenemase-producing Enterobacteriaceae from rectal samples:a role for enrichment?[J].J Hosp Infect,2018,98(3):270-274.
[12] 薄晓霞,刘丽菲,刘颖,等.替加环素联合舒巴坦及法罗培南治疗耐药性老年呼吸机相关性肺炎疗效观察[J].中华实用诊断与治疗杂志,2017,31(2):172-173.
[13] 向贇,汪在华,蔡萍,等.根据β-内酰胺酶选择抗生素对降低细菌性重症肺炎患儿抗生素相关性腹泻发生率的作用[J].中国当代儿科杂志,2016,18(10):1001-1004.
[14] 林秀娟,唐纪文,钟丽红,等.血必净注射液对脓毒症患者凝血功能及预后的影响[J].中国药房,2016,27(5):653-654.
[15] SAMARA P,MIRIAGOU V,ZACHARIADIS M,et al.A fragment of the alarmin prothymosin α as a novel biomarker in murine models of bacteria-induced sepsis[J].Oncotarget,2017,8(30):48635-48649.
[16] 周建.血必净注射液对老年肺感染患者T细胞免疫功能的影响[J].中国中医药科技,2016,23(6):708-709.
[17] CANTIN A M,HANRAHAN J W.Thymosin α1:a single drug with multiple targets in cystic fibrosis[J].Nat Med,2017,23(5):536-538.
[18] 姚兰,刘亚男,侯果,等.血必净注射液在重症肺炎中对机体免疫功能的调控研究[J].湖北中医药大学学报,2017,19(5):35-38.
[19] 陈山.血必净注射液对重症肺炎病人的疗效及其对细胞免疫及炎性因子的影响[J].安徽医药,2017,21(1):127-129.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |