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目的:对比分析血必净注射液对脓毒症患者炎性反应和凝血功能的影响,以指导临床治疗。方法:纳入ICU住院治疗的脓毒症患者80例,随机均分为两组各40例:对照组予常规综合治疗,观察组加用血必净注射液。持续治疗1周后,对比两组治疗前后外周血炎性反应指标,包括肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-8、IL-10、淋巴细胞亚群比例(CD4+/CD8+)、NK细胞水平;凝血功能指标,包括血小板计数(PLT)、凝血酶原时间(PT)、纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)。结果:治疗前两组患者外周血炎性反应指标及凝血功能接近,差异无显著意义。治疗后所有患者IL-10、CD4+/CD8+、PLT、FIB均有上升;TNF-α、IL-6、APTT、PT均有下降;对照组NK细胞水平出现下降,观察组出现上升,上述指标与治疗前相比,差异有显著性意义;治疗后观察组上述指标均优于对照组,差异有显著性意义。结论:血必净注射液有助于下调脓毒症患者促炎因子水平、提升抗炎因子水平、提升免疫功能、纠正凝血功能紊乱,这对改善脓毒症患者预后有积极意义。
Objective: To compare and analyze the effect of Xuebijing injection on inflammatory reaction and coagulation function in patients with sepsis to guide the clinical treatment. Methods: Eighty patients with ICU admitted to hospital for treatment of sepsis were randomly divided into two groups of 40 cases. The control group was given conventional comprehensive treatment. The observation group was given Xuebijing injection. After one week of continuous treatment, the indexes of peripheral blood inflammatory reaction including the ratio of tumor necrosis factor-α (TNF-α), interleukin (IL) -8, IL-10 and lymphocyte subsets (CD4 + / CD8 +), NK cell level; coagulation parameters, including platelet count (PLT), prothrombin time (PT), fibrinogen (FIB), activated partial thromboplastin time (APTT). Results: Before treatment, peripheral blood inflammatory response index and coagulation function were close, the difference was not significant. After treatment, the levels of IL-10, CD4 + / CD8 +, PLT and FIB in all the patients increased; the levels of TNF-α, IL-6, APTT and PT decreased; the levels of NK cells in the control group decreased and the observation group increased Before treatment, the difference was significant; after treatment, the above indicators in the observation group were better than the control group, the difference was significant. Conclusion: Xuebijing injection can reduce the levels of proinflammatory cytokines, increase the level of anti-inflammatory cytokines, enhance the immune function and correct the coagulation disorders in sepsis patients, which is of great significance to improve the prognosis of patients with sepsis.