不同剂量的血必净注射液对急性胰腺炎患者肺损伤的保护作用及临床疗效观察

Effect and the clinical efficacy of Xuebijing Injection with different doses on lung functions in severe acute pancreatitis

关键词:  血必净注射液  重症胰腺炎  肺保护

Key words:  Xuebijing Injection  severe acute pancreatitis  protection of lung functions

摘要:

[目的] 研究不同剂量的血必净注射液对急性胰腺炎患者肺损伤的保护作用及临床疗效。[方法] 收集在许昌市中心医院重症医学科、消化内科、肝胆外科住院的急性胰腺炎合并肺损伤患者160例,随机分为血必净注射液50 mL每日两次(A组)、血必净注射液100 mL每日两次(B组)、血必净注射液100 mL每日3次(C组),以及基础治疗的对照组,共4组,各40例,治疗3 d后评价疗效。在治疗前及治疗后进行急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分及急性胰腺炎严重程度床边指数(BISAP)评分,计算氧合指数(PaO₂/FiO₂),B线评分,检测胸水中白介素-6(IL-6)及肿瘤坏死因子(TNF-α)水平。[结果] 治疗前各组APACHEⅡ评分、BISAP评分、PaO₂/FiO₂、B线评分、胸水IL-6及TNF-α水平比较,差异均无统计学意义(P>0.05)。各组各指标的表达水平在治疗前后均具有统计学差异(P<0.05)。治疗3 d后C组胸水IL-6及TNF-α水平较A组、B组均有所下降,差异有统计学意义(P<0.05),C组APACHEⅡ评分、BISAP评分、PaO₂/FiO₂、B线评分较A组有改善,差异有统计学意义(P<0.05),但与B组比较,差异无统计学意义(P>0.05)。[结论] 血必净注射液对急性胰腺炎患者的肺损伤具有保护作用,在一定范围内,不同剂量具有不同的保护作用。

Abstract:

[Objective] To analyze the effect and the clinical efficacy of Xuebijing Injection with different doses on lung functions in severe acute pancreatitis.[Methods] 160 patients with severe acute pancreatitis from ICU,gastroenterology and hepatological surgery departments were selected as the study objects and randomly divided into four groups,Injection with 50 mL bid (group A),100 mL bid (group B) and 100 mL tid (group C),basic treatment (control group).There were 4 groups with 40 cases in each group.The APACHEⅡ,BISAP,PaO₂/FiO₂,B-scores,IL-6 and TNF-α level among the four groups were compared before and after the Xuebijing Injection.[Results] Before treatment,there were no significant differences in the levels of APACHEⅡ,BISAP,PaO₂/FiO₂,B-scores,IL-6 and TNF-α level among the four groups (P>0.05).The expression levels of each index before and after treatment were statistically different (P<0.05).After 3 days treatment,the level of IL-6 and TNF-αamong the three groups were significant different,the levels of IL-6 and TNF-α in group C were significantly decreased than group A and B;the level of APACHE Ⅱ,BISAP,PaO₂/FiO₂,B-scores in group C were significantly improved than group A,but with no significantly differences than group B.[Conclusion] Xuebijing Injection has a protective effect on lung injury in patients with acute pancreatitis.In a certain range,different doses have different protective effects.