摘要
目的 观察早期加用血必净对感染性休克患者血清降钙素原（PCT）的影响.方法 将65例感染性休克患者按随机数字表分为两组,对照组给予抗生素＋早期液体复苏＋纠正酸中毒等基础治疗,血必净组在此基础上全程加用血必净注射液50 ml ＋0.9％氯化钠注射液100 ml静脉滴注,2次/d,共7d.分别于患者进入ICU当天和治疗1、3、5d采集静脉血5ml检测血清C反应蛋白（CRP）和PCT,分别于治疗前和治疗5、7d进行APACHEⅡ评定,观察两组疗效.结果 （1）两组患者入组时基础心率、平均动脉压、PCT、CRP、APACHEⅡ评分等比较差异均无统计学意义（P均＞0.05）.（2）与对照组比较,血必净组治疗1 d PCT和CRP差异均无统计学意义（P均＞0.05）;治疗3d血必净组PCT和CRP均低于对照组[（12.88±3.76）、（16.96±3.96） μg/L,（80.46±14.97）、（86.57±15.84） mg/L],差异均有统计学意义（P均＜0.05）;治疗5d血必净治疗组PCT和CRP均低于对照组[（7.37±2.58）、（12.25±3.32） μg/L,（64.32±11.12）、（72.37±12.42） mg/L],差异均有统计学意义（P均＜0.05）.（3）对照组治疗前和治疗5、7d的APACHEⅡ评分分别为（20.48±4.41）、（16.52±3.45）、（12.78±2.91）分,血必净组治疗前和治疗5、7d的APACHEⅡ评分分别为（20.74±4.73）、（12.48±2.76）、（9.24±6.67）分,两组组内不同时间APACHEⅡ评分两两比较差异均有统计学意义（P均＜0.05）.（4）治疗7d对照组好转15例,迁延10例,死亡8例,有效率为75.8％（25/33）;血必净组好转22例,迁延5例,死亡5例,有效率为84.8％（27/32）,两组有效率比较差异有统计学意义（x2=7.27,P=0.03）.结论 早期应用血必净能降低感染性休克患者体内的PCT水平,促进患者的转归.
Objective To investigate the effects of early Xuebijing injection on procalcitonin （PCT） with septic shock patients.Methods Sixty-five patients with septic shock were randomly divided into the control group and Xuebijing injection group.The patients in Xuebijing injection group were received Xuebijing injection therapy（50 ml Xuebijing ＋ 100 ml 0.9% NaCl injection,2 times/d,for 7 d） besides basic treatment,while in the control group were received basic treatment including antibiotic susceptibility ＋ early fluid resuscitation ＋ correct acidosis.At the entering the ICU day and 1,3,5 d after treatment,patients were collected 5 ml venous blood serum C reactive protein（CRP） and PCT,and before treatment and at the 5th,7th day after treatment conducted APACHE Ⅱ evaluation to observation of curative effect of two groups.Results Before treatment,there were no significant difference in terms of heart rate,blood pressure,PCT,CRP,APACHE Ⅱ scores between the two groups （P 〉 0.05）.There was no significant difference in terms of PCT and CRP between the two groups at the 1 d after treatment（P 〉0.05）.While at the 3th day after treatment,PCT and CRP of Xuebijing group were lower than of control group and the differences were significant （（7.37 ± 2.58） μg/L vs.（12.25 ± 3.32） μg/L,（64.32 ± 11.12） mg/L vs.（72.37 ± 12.42） mg/L;P 〈0.05）.The APACHEⅡ score in control group at before and 5th,7th day after treatment were （20.48 ± 4.41）,（16.52 ± 3.45）,（12.78 ± 2.91） respectively,in Xuebijing injection group were （20.74 ± 4.73）,（12.48 ± 2.76）,（9.24 ± 6.67） respectively.And all indices were significant different time points between groups （P 〈 0.05）.At 7th day after treatment,15 cases were improved,10 cases progressed and 8 cases died in the control group and the effect rate was 75.8% （25/33）.Meanwhile,22 cases were improved,5 cases progressed and 5 cases died in the Xuebijing group and effect rate was 84.8% （27/32）.There was significant difference between two group（x^2 =7.27,P =0.03）.Conclusion Early Xuebijing injection application can inhibit the PCT rtion of septic shock patients and improve the prognosis.
出处
《中国综合临床》
2014年第12期1300-1302,共3页
Clinical Medicine of China
作者简介
通信作者：王红阳，Email：zyning789@126．com
