参麦注射液治疗脓毒症临床效果及对LAC、NSE和S100B蛋白的影响
|
摘要
目的:探讨参麦注射液治疗脓毒症患者临床效果观察及对乳酸(LAC)、神经元特异性烯醇酶(NSE)和S100B蛋白的影响。方法:脓毒症患者100例,按照随机数字表法分为观察组50例与对照组50例。对照组采用常规西医治疗,观察组在对照组基础上结合参麦注射液。两组疗程均为7 d。比较两组治疗前、治疗3 d、治疗7d APACHE Ⅱ评分,血清LAC、NSE和S100B蛋白水平,血流动力学及凝血功能指标变化。结果:两组治疗3 d和7 d APACHE Ⅱ评分较治疗前降低,且治疗7d APACHE Ⅱ评分低于治疗3 d(P<0.05);观察组治疗3 d和7d APACHE Ⅱ评分低于对照组(P<0.05)。两组治疗3 d和7 d血清LAC、NSE和S100B蛋白水平较治疗前降低,且治疗7d血清LAC、NSE和S100B蛋白水平低于治疗3 d(P<0.05);观察组治疗3 d和7 d血清LAC、NSE和S100B蛋白水平低于同期对照组(P<0.05)。两组治疗3 d和7 d MAP和CVP较治疗前增加而HR较治疗前降低(P<0.05);观察组治疗3 d和7 d MAP、HR和CVP和对照组比较无统计学差异(P>0.05)。两组治疗3 d和7 d血小板计数、纤维蛋白原及凝血酶原时间较治疗前降低,且治疗7 d血小板计数、纤维蛋白原及凝血酶原时间低于治疗3 d(P<0.05);观察组治疗3 d和7 d血小板计数、纤维蛋白原及凝血酶原时间低于同期对照组(P<0.05)。结论:参麦注射液治疗脓毒症患者临床效果明显,可降低血清LAC、NSE和S100B蛋白水平,具有重要研究意义。
Objective: To investigate the clinical effects of Shenmai Injection on patients with sepsis and the effects of lactic acid( LAC),neuron specific enolase( NSE) and S100 B protein on the patients. Methods: Totally 100 patients with sepsis admitted were randomly divided into an observation group( 50 cases) and a control group( 50 cases). The control group was treated with routine western medicine,and the observation group was treated with Shenmai Injection on the basis of the control group. The two groups were treated with 7 d. The two groups were compared before treatment,3 d and7 d after treatment,APACHE Ⅱ score,serum levels of LAC,NSE and S100 B protein,hemodynamics and coagulation function index changes. Results: The scores of APACHE Ⅱ 3 d and 7 d after treatment in the two groups were lower than those before treatment,and the APACHE Ⅱ scores 7 d after treatment were lower than those of 3 d after treatment( P <0. 05). The scores of APACHE Ⅱ 3 d and 7 d after treatment in the observation group were lower than those in the control group( P < 0. 05). The levels of serum LAC,NSE and S100 B protein in the two groups were lower than those before treatment,and the levels of serum LAC,NSE and S100 B protein were lower than those 3 d and 7 d after treatment( P <0. 05). The serum levels of LAC,NSE and S100 B 3 d and 7 d after treatment in the observation group were lower than those in the control group( P < 0. 05). After the two groups being treated for 3 d and 7 d,MAP and CVP increased compared with those before treatment,while HR was lower( P < 0. 05). After the observation group being treated for 3 d and7 d,MAP,HR and CVP had no significance compared with those of the control group( P > 0. 05). The platelet count,fibrinogen and prothrombin time of the two groups were lower than those before the treatment,and 7 d after treatment,platelet count,fibrinogen and prothrombin time were lower than those 3 d after treatment( P < 0. 05). The platelet count,fibrinogen and prothrombin time 3 d and 7 d after treatment in observation group were lower than those in the control group( P < 0. 05). Conclusion: Shenmai Injection is effective in the treatment of sepsis,and can reduce the levels of serum LAC,NSE and S100 B protein,and has important research significance.
Objective: To investigate the clinical effects of Shenmai Injection on patients with sepsis and the effects of lactic acid( LAC),neuron specific enolase( NSE) and S100 B protein on the patients. Methods: Totally 100 patients with sepsis admitted were randomly divided into an observation group( 50 cases) and a control group( 50 cases). The control group was treated with routine western medicine,and the observation group was treated with Shenmai Injection on the basis of the control group. The two groups were treated with 7 d. The two groups were compared before treatment,3 d and7 d after treatment,APACHE Ⅱ score,serum levels of LAC,NSE and S100 B protein,hemodynamics and coagulation function index changes. Results: The scores of APACHE Ⅱ 3 d and 7 d after treatment in the two groups were lower than those before treatment,and the APACHE Ⅱ scores 7 d after treatment were lower than those of 3 d after treatment( P <0. 05). The scores of APACHE Ⅱ 3 d and 7 d after treatment in the observation group were lower than those in the control group( P < 0. 05). The levels of serum LAC,NSE and S100 B protein in the two groups were lower than those before treatment,and the levels of serum LAC,NSE and S100 B protein were lower than those 3 d and 7 d after treatment( P <0. 05). The serum levels of LAC,NSE and S100 B 3 d and 7 d after treatment in the observation group were lower than those in the control group( P < 0. 05). After the two groups being treated for 3 d and 7 d,MAP and CVP increased compared with those before treatment,while HR was lower( P < 0. 05). After the observation group being treated for 3 d and7 d,MAP,HR and CVP had no significance compared with those of the control group( P > 0. 05). The platelet count,fibrinogen and prothrombin time of the two groups were lower than those before the treatment,and 7 d after treatment,platelet count,fibrinogen and prothrombin time were lower than those 3 d after treatment( P < 0. 05). The platelet count,fibrinogen and prothrombin time 3 d and 7 d after treatment in observation group were lower than those in the control group( P < 0. 05). Conclusion: Shenmai Injection is effective in the treatment of sepsis,and can reduce the levels of serum LAC,NSE and S100 B protein,and has important research significance.
引文
[1]Casserly B,Phillips G S,Schorr C,et al.Lactate measurements in sepsis-induced tissue hypoperfusion:results from the Surviving Sepsis Campaign database[J].Critical Care Medicine,2015,43(3):567-573.
[2]Vazquezgrande G,Kumar A.Optimizing antimicrobial therapy of sepsis and septic shock:focus on antibiotic combination therapy.[J].Seminars in Respiratory&Critical Care Medicine,2015,36(1):154-166.
[3]Martinod K,Fuchs T A,Zitomersky N L,et al.PAD4-deficiency does not affect bacteremia in polymicrobial sepsis and ameliorates endotoxemic shock.[J].Blood,2015,125(12):1948-1956.
[4]金魁,龙儒瑾,高志凌,等.脓毒症患者ICU延迟收住与急性肾损伤发病率及其相关死亡风险的研究[J].中国急救医学,2016,36(10):865-870.
[5]于洋,袁光雄.脓毒症流行病学的研究进展[J].临床急诊杂志,2015,19(6):416-418.
[6]张玉景,张君利,李鹏,等.他汀类药物联合参麦注射液治疗脓毒症的机制研究[J].海南医学院学报,2016,22(23):2911-2914.
[7]黄增峰,陈如康,黄学仄,等.参麦注射液对脓毒症患者器官功能保护作用的临床研究[J].中国中西医结合急救杂志,2010,17(5):282-284.
[8]Schlapbach L J,Straney L,Alexander J,et al.Mortality related to invasive infections,sepsis,and septic shock in critically ill children in Australia and New Zealand,2002-13:a multicentre retrospective cohort study.[J].Lancet Infectious Diseases,2015,15(1):46-54.
[9]Acheampong A,Vincent J L.A positive fluid balance is an independent prognostic factor in patients with sepsis[J].Critical Care,2015,19(1):1-7.
[10]周袁申,陈昱志,李婷,等.参麦注射液对气阴两虚型血瘀证脓毒症患者凝血功能障碍的影响[J].中国中西医结合急救杂志,2016,23(3):240-244.
[11]Lood R,Winer B Y,Pelzek A J,et al.Novel phage lysins capable of killing the multidrug resistant Gram-negative bacterium Acinetobacter baumannii in a mouse sepsis model[J].Antimicrob Agents Chemother,2015,59(4):1983-1991.
[12]宁小平,王金莉,何东阳,等.参麦注射液对脓毒血症患者血清细胞因子及超敏C-反应蛋白的影响[J].中国当代医药,2012,19(18):78-79.
[13]周旋,徐明,唐旭,等.参麦注射液及乌司他丁对重症脓毒症患者微循环的影响[J].中外医学研究,2013,27(10):124-125.
[14]何聪,王显雷,王志刚,等.参麦注射液联合中药大黄制剂对脓毒症合并急性肾损伤患者免疫功能的影响[J].中国医院药学杂志,2015,35(19):1759-1761.
[15]刁孟元,王涛,崔云亮,等.早期动脉血乳酸对脓毒症患者预后的评估[J].中国急救医学,2013,33(7):596-600.
[16]谢辉,张震环,邢娟.降钙素原和血乳酸对脓毒症合并弥散性血管内凝血的诊断价值[J].微循环学杂志,2016,26(2):21-23.
[17]刘秀娟,王炳今.血浆脑钠肽及神经元特异性烯醇酶在脓毒症患者中的表达及临床意义[J].现代诊断与治疗,2012,23(10):1625-1626.
[18]占凌辉,蔡秋雅,王金领,等.血清神经元特异性烯醇化酶水平与脓毒症相关性脑病的关系[J].内科急危重症杂志,2013,19(2):106.
[19]廖谷清.脓毒症脑病患者血清和脑脊液SIOOB浓度与脑电图异常的关系[J].中国现代医生,2017,19(8):8-10.
[20]夏汉兵,余道兵,刘喜,等.脓毒性脑病患儿血清神经元特异性烯醇酶及S100B蛋白的表达及其临床意义[J].湖北科技学报(医学版),2009,23(4):297-299.
[2]Vazquezgrande G,Kumar A.Optimizing antimicrobial therapy of sepsis and septic shock:focus on antibiotic combination therapy.[J].Seminars in Respiratory&Critical Care Medicine,2015,36(1):154-166.
[3]Martinod K,Fuchs T A,Zitomersky N L,et al.PAD4-deficiency does not affect bacteremia in polymicrobial sepsis and ameliorates endotoxemic shock.[J].Blood,2015,125(12):1948-1956.
[4]金魁,龙儒瑾,高志凌,等.脓毒症患者ICU延迟收住与急性肾损伤发病率及其相关死亡风险的研究[J].中国急救医学,2016,36(10):865-870.
[5]于洋,袁光雄.脓毒症流行病学的研究进展[J].临床急诊杂志,2015,19(6):416-418.
[6]张玉景,张君利,李鹏,等.他汀类药物联合参麦注射液治疗脓毒症的机制研究[J].海南医学院学报,2016,22(23):2911-2914.
[7]黄增峰,陈如康,黄学仄,等.参麦注射液对脓毒症患者器官功能保护作用的临床研究[J].中国中西医结合急救杂志,2010,17(5):282-284.
[8]Schlapbach L J,Straney L,Alexander J,et al.Mortality related to invasive infections,sepsis,and septic shock in critically ill children in Australia and New Zealand,2002-13:a multicentre retrospective cohort study.[J].Lancet Infectious Diseases,2015,15(1):46-54.
[9]Acheampong A,Vincent J L.A positive fluid balance is an independent prognostic factor in patients with sepsis[J].Critical Care,2015,19(1):1-7.
[10]周袁申,陈昱志,李婷,等.参麦注射液对气阴两虚型血瘀证脓毒症患者凝血功能障碍的影响[J].中国中西医结合急救杂志,2016,23(3):240-244.
[11]Lood R,Winer B Y,Pelzek A J,et al.Novel phage lysins capable of killing the multidrug resistant Gram-negative bacterium Acinetobacter baumannii in a mouse sepsis model[J].Antimicrob Agents Chemother,2015,59(4):1983-1991.
[12]宁小平,王金莉,何东阳,等.参麦注射液对脓毒血症患者血清细胞因子及超敏C-反应蛋白的影响[J].中国当代医药,2012,19(18):78-79.
[13]周旋,徐明,唐旭,等.参麦注射液及乌司他丁对重症脓毒症患者微循环的影响[J].中外医学研究,2013,27(10):124-125.
[14]何聪,王显雷,王志刚,等.参麦注射液联合中药大黄制剂对脓毒症合并急性肾损伤患者免疫功能的影响[J].中国医院药学杂志,2015,35(19):1759-1761.
[15]刁孟元,王涛,崔云亮,等.早期动脉血乳酸对脓毒症患者预后的评估[J].中国急救医学,2013,33(7):596-600.
[16]谢辉,张震环,邢娟.降钙素原和血乳酸对脓毒症合并弥散性血管内凝血的诊断价值[J].微循环学杂志,2016,26(2):21-23.
[17]刘秀娟,王炳今.血浆脑钠肽及神经元特异性烯醇酶在脓毒症患者中的表达及临床意义[J].现代诊断与治疗,2012,23(10):1625-1626.
[18]占凌辉,蔡秋雅,王金领,等.血清神经元特异性烯醇化酶水平与脓毒症相关性脑病的关系[J].内科急危重症杂志,2013,19(2):106.
[19]廖谷清.脓毒症脑病患者血清和脑脊液SIOOB浓度与脑电图异常的关系[J].中国现代医生,2017,19(8):8-10.
[20]夏汉兵,余道兵,刘喜,等.脓毒性脑病患儿血清神经元特异性烯醇酶及S100B蛋白的表达及其临床意义[J].湖北科技学报(医学版),2009,23(4):297-299.