参麦注射液对主动脉夹层腔内隔绝手术患者中性粒细胞弹性蛋白酶的影响
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摘要
目的:评价参麦注射液对主动脉夹层腔内隔绝手术患者中性粒细胞弹性蛋白酶(neutrophil elastase,NE)的影响,探讨其对该类患者术后肺功能保护的作用机制。方法:选取2015年7月-2017年12月在珠海市第二人民医院心胸外科行主动脉夹层腔内隔绝手术符合纳入标准的40例患者,按照随机数字表法分为治疗组与对照组,每组20例。对照组常规西医治疗,治疗组在常规治疗基础上加用参麦注射液治疗。测定比较两组术前(T0)、术后30 min(T1)、术后24 h(T2)、术后72 h(T3)NE、氧合指数等。结果:两组NE手术后逐渐下降,治疗组较对照组下降明显(P<0.05)。两组氧合指数均逐渐升高,但治疗组较对照组升高明显(P<0.05)。结论:参麦注射液可通过降低主动脉夹层腔内隔绝术后炎症反应(NE)起到一定的肺保护作用。
Objective:To evaluate the effect of Shenmai Injection on neutrophil elastase(NE)in patients with aortic dissection(AD)endovascular isolation,and explore the mechanism on the postoperative pulmonary function for patients.Method:A total of 40 patients in our hospital from July 2015 to December 2017 were randomly divided into treatment group and control group according to table of random numbers,20 cases in each group.The control group was treated conventional western medicine treatment,and the treatment group was treated on the basis of conventional treatment combined with Shenmai Injection.The oxygenation index and NE at pre-operation(T0),30 min after operation(T1),24 h after operation(T2),and 24 h after operation(T3) were respectively determined and compared between two groups.Result:After the treatment,the NE level in the treatment group was lower than that in the control group(P<0.05).The oxygenation index in the treatment group was significantly higher than that in the control group(P<0.05).Conclusion:Shenmai Injection can reduce the postoperative inflammatory reaction(NE)in the aortic dissection.
Objective:To evaluate the effect of Shenmai Injection on neutrophil elastase(NE)in patients with aortic dissection(AD)endovascular isolation,and explore the mechanism on the postoperative pulmonary function for patients.Method:A total of 40 patients in our hospital from July 2015 to December 2017 were randomly divided into treatment group and control group according to table of random numbers,20 cases in each group.The control group was treated conventional western medicine treatment,and the treatment group was treated on the basis of conventional treatment combined with Shenmai Injection.The oxygenation index and NE at pre-operation(T0),30 min after operation(T1),24 h after operation(T2),and 24 h after operation(T3) were respectively determined and compared between two groups.Result:After the treatment,the NE level in the treatment group was lower than that in the control group(P<0.05).The oxygenation index in the treatment group was significantly higher than that in the control group(P<0.05).Conclusion:Shenmai Injection can reduce the postoperative inflammatory reaction(NE)in the aortic dissection.
引文
[1]景在平,陆清声.主动脉夹层的腔内治疗进展[J].临床外科杂志,2012,20(5):303-304.
[2]Wang Y,Xue S,Zhu H.Risk factors for operative hypoxemia in patients undergoing stanford a aortic dissection surgery[J].J Cardiothorac Surg,2013,30(8):118.
[3]马志高,金沐,程卫平,等.急性主动脉夹层并发急性肺损伤的研究进展[J].心肺血管病杂志,2015,34(4):319-321.
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[5]李西西,梁余良,张娟,等.中性粒细胞弹性蛋白酶及其在急性肺损伤中的应用[J].预防医学论坛,2017,23(1):74-76.
[6]景赫,卢家凯,金沐,等.急性主动脉夹层围术期急性肺损伤与炎性细胞因子的相关性研究[J].心肺血管病杂志,2015,34(4):287-290.
[7]杨彦伟,金沐,董秀华,等.急性Stanford A型主动脉夹层致急性肺损伤相关危险因素分析[J].心肺血管病杂志,2016,35(2):124-128.
[8]李明,法宪恩,杨景学,等.急性主动脉夹层合并急性肺损伤患者细胞因子表达的分析[J].河南外科学杂志,2014,20(4):3-5.
[9]景在平,陆清声,冯家烜.主动脉夹层腔内隔绝术后并发症[J/OL].中国血管外科杂志:电子版,2012,4(4):196-198.
[10]Schillinger M,Domanovits H,Bayegan K,et al.C-reactive protein andmortality in patients with acute aortic disease[J].Intensive Care Med,2002,28(6):740-745.
[11]钟毓贤.中性粒细胞弹性蛋白酶抑制剂能够治疗小鼠急性肺损伤后的肺纤维化[J].中华危重病急救医学,2012,24(4):256.
[12]袁亮,朱曦.中性粒细胞弹性蛋白酶及其抑制剂在急性呼吸窘迫综合征中作用的研究进展[J].中华危重病急救医学,2014,26(5):364-368.
[13]凌海平,杭春华.中性粒细胞弹性蛋白酶在脑损伤中的作用机制[J].医学研究生学报,2013,26(1):73-76.
[14]Lee W L,Downey G P.Neutrophil activation and acute lung injury[J].Current Crit Care,2001,7(1):1-7.
[15]李阳,黄寅銮,林洁娜,等.参麦注射液临床应用安全性评价[J].中国中医药信息杂志,2013,20(3):104-105.
[16]于齐宏,杜奕奇,李兆申,等.参麦注射液减轻大鼠重症急性胰腺炎相关性肺损伤[J].第二军医大学学报,2013,34(11):1183-1186.
[17]曹俊华.参麦注射液联合注射用乌司他丁治疗创伤后早期急性肺损伤的临床观察[J].河北中医,2012,34(8):1206-1208.
[18]刘小芳.参麦注射液治疗急性肺损伤的疗效及对血清ICAM-1、ET-1及NO的影响[J].现代中西医结合杂志,2017,26(25):2784-2786.
[19]方青.参麦注射液对大鼠急性肺损伤疗效的观察[D].长春:吉林大学,2012.
[20]梅志军,景在平.腹主动脉瘤腔内隔绝术后全身炎症反应的特点[J].介入放射学杂志,2003,12(1):66-68.
[21]Kurabayashi M,Okishige K,Azegami K,et al.Reduction of the Pa O2/Fi O2 ratio in acute aortic dissection-relationship between the extent of dissection and inflammation[J].Circ J,2010,74(10):2066-2073.
[22]李潮杰,余瑜,陈杰.参麦注射液对主动脉夹层腔内隔绝手术患者呼吸功能影响的临床观察[J].甘肃医药,2015,34(7):497-499.
[23]陈杰,李潮杰.参麦注射液在主动脉夹层腔内隔绝术患者中的应用效果[J].中国当代医药,2016,23(9):84-86.
[24]邹立华,李惠,陈小丹,等.乌司他丁联合参麦注射液治疗ALI的疗效研究[J].临床肺科杂志,2012,17(10):1800-1801.
[2]Wang Y,Xue S,Zhu H.Risk factors for operative hypoxemia in patients undergoing stanford a aortic dissection surgery[J].J Cardiothorac Surg,2013,30(8):118.
[3]马志高,金沐,程卫平,等.急性主动脉夹层并发急性肺损伤的研究进展[J].心肺血管病杂志,2015,34(4):319-321.
[4]杨斌,陈海龙.中性粒细胞弹性蛋白酶在重症急性胰腺炎并急性肺损伤发病中的表达和意义[J].临床军医杂志,2012,40(4):765-769.
[5]李西西,梁余良,张娟,等.中性粒细胞弹性蛋白酶及其在急性肺损伤中的应用[J].预防医学论坛,2017,23(1):74-76.
[6]景赫,卢家凯,金沐,等.急性主动脉夹层围术期急性肺损伤与炎性细胞因子的相关性研究[J].心肺血管病杂志,2015,34(4):287-290.
[7]杨彦伟,金沐,董秀华,等.急性Stanford A型主动脉夹层致急性肺损伤相关危险因素分析[J].心肺血管病杂志,2016,35(2):124-128.
[8]李明,法宪恩,杨景学,等.急性主动脉夹层合并急性肺损伤患者细胞因子表达的分析[J].河南外科学杂志,2014,20(4):3-5.
[9]景在平,陆清声,冯家烜.主动脉夹层腔内隔绝术后并发症[J/OL].中国血管外科杂志:电子版,2012,4(4):196-198.
[10]Schillinger M,Domanovits H,Bayegan K,et al.C-reactive protein andmortality in patients with acute aortic disease[J].Intensive Care Med,2002,28(6):740-745.
[11]钟毓贤.中性粒细胞弹性蛋白酶抑制剂能够治疗小鼠急性肺损伤后的肺纤维化[J].中华危重病急救医学,2012,24(4):256.
[12]袁亮,朱曦.中性粒细胞弹性蛋白酶及其抑制剂在急性呼吸窘迫综合征中作用的研究进展[J].中华危重病急救医学,2014,26(5):364-368.
[13]凌海平,杭春华.中性粒细胞弹性蛋白酶在脑损伤中的作用机制[J].医学研究生学报,2013,26(1):73-76.
[14]Lee W L,Downey G P.Neutrophil activation and acute lung injury[J].Current Crit Care,2001,7(1):1-7.
[15]李阳,黄寅銮,林洁娜,等.参麦注射液临床应用安全性评价[J].中国中医药信息杂志,2013,20(3):104-105.
[16]于齐宏,杜奕奇,李兆申,等.参麦注射液减轻大鼠重症急性胰腺炎相关性肺损伤[J].第二军医大学学报,2013,34(11):1183-1186.
[17]曹俊华.参麦注射液联合注射用乌司他丁治疗创伤后早期急性肺损伤的临床观察[J].河北中医,2012,34(8):1206-1208.
[18]刘小芳.参麦注射液治疗急性肺损伤的疗效及对血清ICAM-1、ET-1及NO的影响[J].现代中西医结合杂志,2017,26(25):2784-2786.
[19]方青.参麦注射液对大鼠急性肺损伤疗效的观察[D].长春:吉林大学,2012.
[20]梅志军,景在平.腹主动脉瘤腔内隔绝术后全身炎症反应的特点[J].介入放射学杂志,2003,12(1):66-68.
[21]Kurabayashi M,Okishige K,Azegami K,et al.Reduction of the Pa O2/Fi O2 ratio in acute aortic dissection-relationship between the extent of dissection and inflammation[J].Circ J,2010,74(10):2066-2073.
[22]李潮杰,余瑜,陈杰.参麦注射液对主动脉夹层腔内隔绝手术患者呼吸功能影响的临床观察[J].甘肃医药,2015,34(7):497-499.
[23]陈杰,李潮杰.参麦注射液在主动脉夹层腔内隔绝术患者中的应用效果[J].中国当代医药,2016,23(9):84-86.
[24]邹立华,李惠,陈小丹,等.乌司他丁联合参麦注射液治疗ALI的疗效研究[J].临床肺科杂志,2012,17(10):1800-1801.