血必净注射液对脓毒症患者血浆组蛋白H4的影响及意义

Effects and clinical value of Xuebijing Injection on plasma histone H4 in patients with sepsis

关键词:  血必净注射液  胞外组蛋白H4  脓毒症

Key words:  Xuebijing Injection  extracellular histone H4  sepsis

摘要:

[目的] 观察血必净注射液对脓毒症患者血浆组蛋白H4的影响及意义。[方法] 对2017年7月-2018年6月天津医科大学总医院急诊医学科收治的60例脓毒症患者，随机分为对照组和治疗组。检测患者入院时、24及72 h时血浆组蛋白H4、D-二聚体和白介素-6（IL-6）水平。收集患者性别、年龄、急性生理与慢性健康评分（APACHEⅡ）及序贯器官衰竭评估评分（SOFA），随访28 d生存状态。[结果] 与对照组相比，治疗组患者24 h时血浆组蛋白H4、D-二聚体和IL-6显著降低（P<0.01）。72 h时两组间D-二聚体和IL-6水平无统计学差异（P>0.05）。与对照组相比，治疗组72 h时的APACHEⅡ及SOFA分值有统计学差异（P<0.01）。死亡患者入院时EH4水平显著高于存活者（P<0.01）。[结论] 血必净注射液可能通过降低脓毒症患者血浆组蛋白H4，纠正凝血功能紊乱和过度炎症反应，改善病情严重程度。

Abstract:

[Objective] The aim of this study was to observe the effect and clinical value of Xuebijing(XBJ) Injection on plasma histone H4 in patients with sepsis. [Methods] Sixty septic patients admitted to the department of emergency medicine,Tianjin Medical University General Hospital from July 2017 to June 2018,were randomly assigned into the control group (n=30) and intervention group (n=30). Plasma was collected at 0,24 and 72 hrs on admission. The gender,age,APACHE Ⅱ and SOFA scores and 28-day mortality between the two groups were collected. [Results] Compared with the control group,plasma histone H4,D-dimer and IL-6 levels were significantly reduced at 24 hrs in the intervention group (P<0.01). There was no significant difference in plasma D-dimer and IL-6 levels between the two groups at 72 hrs (P>0.05). Compared with the control group,the APACHE Ⅱ and SOFA scores at 72 hrs in the intervention group were statistically reduced (P<0.01). Plasma histone H4 levels were associated with 28-day mortality on admission (P< 0.01). [Conclusion] XBJ injection may correct coagulopathy and inflammatory response,and improve the severity of the disease via reducing histone H4 in septic patients.