血必净对脓毒症患者去甲肾上腺素用量的影响

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摘要

目的探讨脓毒症早期应用血必净注射液（XBJ）对去甲肾上腺素（NE）的影响。方法选取2020 年3 月至2023 年3 月在广州市中西医结合医院住院的108 例需要使用NE 的脓毒症患者作为研究对象。在相同液体复苏的基础上，按照随机数字表法将患者分为观察组（n=54）与对照组（n=54）。观察组在基础治疗的情况下加用XBJ 50 ml+0.9%氯化钠溶液100 ml，每12 小时1 次；对照组在基础治疗的情况下输注150 ml 0.9%氯化钠溶液，每12 小时1 次。观察两组患者NE 用量情况、降钙素原（PCT）、白细胞介素-6（IL-6）、C 反应蛋白（CRP）、白细胞计数（WBC）、中性粒细胞/淋巴细胞比（NLR）、血小板计数（PLT）、血乳酸（Lac）、序贯性器官功能衰竭评估（SOFA）、急性生理与慢性健康评分Ⅱ（APACHEⅡ）以及ICU 住院时间。结果两组患者在维持MAP≥65 mmHg 水平时NE用量比较，差异无统计学意义（P＞0.05）；但观察组全病程中NE 的总用量低于对照组，差异有统计学意义（P＜0.05）；观察组NE 使用总时间短于对照组，差异有统计学意义（P＜0.05）。观察组的PCT、IL-6、CRP、NLR、Lac、SOFA 评分以及APACHEⅡ评分均低于对照组，差异有统计学意义（P＜0.05）；两组患者的WBC、PLT 变化以及ICU 住院时间比较，差异无统计学意义（P＞0.05）。结论在脓毒症早期使用XBJ 可以有效减少NE 用量，并具有减轻炎症、改善循环作用。

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	梁志锋王震奎黄文东付正辉

关键词 ：血必净, 去甲肾上腺素, 脓毒症, 炎症, 微循环

Abstract：

Objective To investigate the effect of Xuebijing Injection(XBJ)on Norepinephrine(NE)in early stage of sepsis.Methods A total of 108 patients with sepsis requiring NE from March 2020 to March 2023 in Guangzhou Hospital of Integrated Traditional Chinese and Western Medicine were selected as research objects.On the basis of the same fluid resuscitation,they were divided into observation group(n=54)and control group(n=54)according to random number table method.Observation group was treated with XBJ 50 ml+0.9% Sodium Chloride Solution 100 ml,once every 12 hours.The control group was infused with 150 ml 0.9% Sodium Chloride Solution every 12 hours under the condition of basic treatment.NE dosage,procalcitonin(PCT),interleukin-6(IL-6),C-reactive protein(CRP),white blood cell count(WBC),neutrophil/lymphocyte ratio(NLR),platelet(PLT),lactate(Lac),sequential organ failure assessment(SOFA),acute physiology and chronic health assessment Ⅱ (APACHEⅡ),and length of ICU stay of the two groups were observed.Results There was no significant difference in NE dosage between two groups when MAP≥65 mmHg level was maintained(P＞0.05).However,the total NE consumption in the observation group was lower than that in the control group,and the difference was statistically significant (P＜0.05).The total NE use time of observation group was shorter than that of control group,and the difference was statistically significant (P＜0.05).The scores of PCT,IL-6,CRP,NLR,Lac,SOFA and APACHEⅡin observation group were lower than those in control group,with statistical significances (P＜0.05).There were no significant differences in WBC,PLT and length of ICU stay between the two groups(P＞0.05).Conclusion XBJ in early stage of sepsis can effectively reduce NE dosage,reduce inflammation and improve circulation.

Key words： Xuebijing Injection Norepinephrine Sepsis Inflammation Microcirculation

作者简介: 王震奎（1976-），男，广东广州人，硕士，副主任医师，硕士研究生导师；研究方向：急性肾功能衰竭。

引用本文:

梁志锋王震奎黄文东付正辉. 血必净对脓毒症患者去甲肾上腺素用量的影响[J]. 中国当代医药, 2024, 31(12): 27-31.
LIANG Zhifeng WANG Zhenkui HUANG Wendong FU Zhenghui. Effect of Xuebijing Injection on the dosage of Norepinephrine in patients with sepsis. 中国当代医药, 2024, 31(12): 27-31.

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