早期参附注射液对老年重症肺炎患者降钙素原及脑钠肽的影响

The influence of early application of Shenfu injection on procalcitionin and brain natriuretic peptide in elderly patients with severe pneumonia

关键词:  参附注射液  老年重症肺炎  降钙素原  脑钠肽

Key words:  Shenfu injection  severe pneumonia  procalcitionin  brain natriuretic peptide

摘要:

[目的] 观察早期应用参附注射液对老年重症肺炎患者降钙素原(PCT)及脑钠肽(BNP)的影响。[方法] 84例老年重症肺炎患者按随机数字表法分为对照组与参附注射液组。对照组(42例)接受常规综合治疗(抗菌药物、呼吸机通气、营养支持等), 参附注射液组(42例)在此基础上全程加用参附注射液。分别在治疗前、治疗后1 d、3 d、5 d检测血浆BNP和PCT.结合患者7 d内的病情情况分析参附注射液对老年重症肺炎的治疗效果、对血浆BNP及PCT的影响。[结果] 与对照组比较, 参附注射液组治疗后1 d PCT和BNP差异无统计学意义(P>0.05).3 d和5 d参附注射液组PCT和BNP水平均低于对照组, 差异有统计学意义(P<0.05).3 d和5 d参附注射液组APACHEⅡ评分均低于对照组, 差异有统计学意义(P<0.05).治疗后7 d对照组好转10例, 迁延17例, 死亡15例;参附注射液组好转19例, 迁延14例, 死亡9例, 差异有统计学意义(P<0.05).两组中医证候比较, 参附注射液组的总有效率为90.5%, 明显高于对照组83.3%.[结论]早期应用参附注射液降低老年重症肺炎患者体内PCT及BNP水平, 促进患者的转归。

Abstract:

[Objective] To investigate the influence of early application of Shenfu injection on procalcitionin(PCT)and brain natriuretic peptide (BNP) in elderly patients with severe pneumonia. [Methods] Eghtity-four elderly patients with severe pneumonia were divided into Shenfu injection group (42 cases) and control group (42 cases).The control group received basic treatment (anti-inflammatory and nutritional support etc). While the Shenfu injection group received early application of Shenfu injection therapy besides basic treatment. PCT and BNP level were measured before and after 1 d, 3 d, 5 d;and the effects of early application of Shenfu injection on PCT and BNP in elderly patients with severe pneumonia were analyzed combining the patients condition within 7 d. [Results] Compared with the control group, there were no significant difference in the PCT and BNP level after 1 d in Shenfu injection group (P>0.05). The PCT and BNP level were lower in Shenfu injection group than those in control group after 3d and 5d (P<0.05). The score of APACHE II was better than those in control group after 3 d and 5 d (P<0.05).Ten cases were improved, 17cases progressed and 15 cases died in the control group, while 19 cases were improved, 14 cases progressed and 9 cases died in Shenfu injection group after 7 d. Compare with the traditional Chinese medicine syndromes between the two groups, the total effective rate (90.5%) in Shenfu injection group was higher than in control group. [Conclusion] Early application of Shenfu injection can inhibit the PCT and BNP level in elderly patients with severe pneumonia and improve the prognosis.