摘要
目的观察参附注射液联合低剂量氢化可的松对脓毒症多脏器功能障碍综合征患者血浆降钙素原(PCT)和单核细胞表面人类白细胞抗原DR位点(HLA-DR)水平的影响。方法将118例脓毒症多脏器功能障碍综合征患者按随机数字表法分为对照组(39例)、观察1组(39例)和观察2组(40例)。对照组行常规治疗,观察1组在常规综合治疗基础上应用参附注射液100 m L,2次/d,共7 d;观察2组在观察1组基础上应用低剂量氢化可的松200mg/d,静脉注射,连用14 d。分别于入院当天、治疗后1 d、3 d和7 d采集患者清晨空腹静脉血5 m L,检测PCT、HLA-DR和过氧化脂质(LPO)水平。并记录治疗14 d内患者的死亡情况。结果治疗14 d内,对照组、观察1组和观察2组病死率[分别是61.5%(24/39)、41.0%(16/39)和25.0%(10/40)]依次降低(χ2=8.150,P<0.05)。治疗前和治疗后1 d时3组患者血浆PCT、HLA-DR和LPO水平差异均无统计学意义;治疗后3 d和7 d时,对照组、观察1组和观察2组血浆PCT、LPO水平均依次降低,HLA-DR水平依次升高(均P<0.05)。结论参附注射液联合低剂量氢化可的松可有效降低PCT水平,提高HLA-DR水平,促进脓毒症多脏器功能障碍综合征患者的转归。
Objective To explore the effects of Shenfu injection combined with low-dose hydrocortisone on plasma lev-els of human leukocyte antigen（HLA）-DR and procalcitonin（PCT） in patients with septic multiple organ dysfunction syn-drome. Methods A total of 118 patients with septic multiple organ dysfunction syndrome were divided into three groups：control group（n=39）, experimental group 1（n=39） and experimental group 2（n=40）. The control group received conventioanlmedicine therapy, while the experimental group 1 received Shenfu injection（100 m L, 2 /d, for 7 d） combined with conventio-anl medicine therapy, and the experimental group 2 received Shenfu injection combined with low-dose hydrocortisone（200mg/d, for 14 d） besides conventional medicine therapy. The peripheral blood samples were collected for the detection ofHLA-DR, PCT and lipoperoxide（LPO） before treatment, 1 d, 3 d amd 7 d after treatment. The mortality in 14 d was record-ed. Results The mortality rates in 14 d were 61.5%（24/39）, 41.0%（16/39） and 25.0%（10/40） for control group, experimen-tal group 1 and experimental group 2（χ2=8.15, P0.05）. There were no significant differences in PCT, HLA-DR and LPOlevels before treatment and 1 d after treatment between the three groups（P0.05）. The plasma levels of PCT and LPO weresignificantly decreased in control group, experimental group 1 and experimental group 2 after 3-d and 7-d treatment, but thelevels of HLA- DR was significantly increased（P 0.05）. Conclusion The combination therapy of Shenfu injectionand low-dose hydrocortisone can effectively reduce PCT level and increase HLA-DR level, which promotes the improve-ment of patients with septic multiple organ dysfunction syndrome.
出处
《天津医药》
CAS
2016年第4期501-504,共4页
Tianjin Medical Journal
基金
河北省医学科学研究重点课题(20140500)
