陈敏, 周伟君, 车在前, 马丽, 赵冰, 邵建伟, 毛恩强, 陈尔真. 血必净注射液对急诊重度脓毒症患者凝血功能影响[J]. 职业卫生与应急救援, 2023, 41(4): 421-425. DOI: 10.16369/j.oher.issn.1007-1326.2023.04.006
引用本文: 陈敏, 周伟君, 车在前, 马丽, 赵冰, 邵建伟, 毛恩强, 陈尔真. 血必净注射液对急诊重度脓毒症患者凝血功能影响[J]. 职业卫生与应急救援, 2023, 41(4): 421-425. DOI: 10.16369/j.oher.issn.1007-1326.2023.04.006
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CHEN Min, ZHOU Weijun, CHE Zaiqian, MA Li, ZHAO Bing, SHAO Jianwei, MAO Enqiang, CHEN Erzhen. Effect of Xuebijing injection on coagulation function in emergency patients with severe sepsis[J]. Occupational Health and Emergency Rescue, 2023, 41(4): 421-425. DOI: 10.16369/j.oher.issn.1007-1326.2023.04.006
Citation: CHEN Min, ZHOU Weijun, CHE Zaiqian, MA Li, ZHAO Bing, SHAO Jianwei, MAO Enqiang, CHEN Erzhen. Effect of Xuebijing injection on coagulation function in emergency patients with severe sepsis[J]. Occupational Health and Emergency Rescue, 2023, 41(4): 421-425. DOI: 10.16369/j.oher.issn.1007-1326.2023.04.006
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血必净注射液对急诊重度脓毒症患者凝血功能影响

Effect of Xuebijing injection on coagulation function in emergency patients with severe sepsis

    摘要
  • 摘要:
      目的  探讨血必净注射液治疗急诊重度脓毒症患者的疗效，及其对机体凝血功能的影响。
      方法  采用随机数字表法将78例脓毒症患者分为对照组（n=39）和血必净组（n=39），两组患者均按照《2016年脓毒症和感染性休克处理国际指南》给予常规抗脓毒症集束化治疗，血必净组在常规治疗基础上给予血必净注射液治疗，对照组给予等量氯化钠注射液治疗。检测并比较两组患者治疗前和治疗7 d后血小板计数（platelet count，PLT）、凝血功能、血栓弹力图数值结果，以及两组急性生理学和慢性健康状况评价系统Ⅱ（acute physiology and chronic health evaluation Ⅱ，APACHE Ⅱ）评分、急诊重症监护室住院时间和28 d病死率。
      结果  治疗7 d后，血必净组患者PLT计数显著较前上升，纤维蛋白降解产物（fibrin/fibrinogen degradation products，FDP）较前明显下降（P均＜0.05）；对照组患者PLT计数依旧下降（P＜0.01）。治疗7 d后，血必净组患者FDP、D-二聚体低于对照组（P＜0.01），凝固时间明显缩短，α角、最大血块强度（maximum clot strength，MA）值、CI-综合凝血指数明显增大，且均优于对照组（P＜0.05）。对照组以上指标在治疗前后差异均无统计学意义（P＞0.05）。治疗7 d后，两组患者APACH Ⅱ评分均较治疗前下降（P＜0.05），但血必净组表现更优（P＜0.05）。血必净组28 d死亡率为17.95%，低于对照组的23.08%。
      结论  常规对症治疗联合血必净注射液能有效改善脓毒症患者的凝血功能，血必净注射液在脓毒症患者治疗中有积极作用。

     

    Abstract:
      Objective  To explore the efficacy of Xuebijing injection in the treatment of emergency patients with severe sepsis and its impact on coagulation function.
      Methods  Seventy-eight patients with severe sepsis were randomly divided into the control group (n=39) and the Xuebijing group (n=39) by the random number table method. All patients in both groups were treated with routine anti-sepsis bundle therapy according to the 2016 International Guidelines for the Treatment of Sepsis and Septic Shock. In addition to these routine treatments, the Xuebijing group was treated with a Xuebijing injection, while the control group was given an equal amount of sodium chloride. The platelet count (PLT), coagulation function, thromboelastography (TEG) values, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, the stay time at the emergency intensive care unit, and the fatality rate within 28 days were compared between these two groups before and after 7 days of treatment.
      Results  After 7 days of treatment, the PLT count in the Xuebijing group increased significantly, and the fibrin/fibrinogen degradation products (FDP) decreased significantly (P < 0.05); the PLT count in the control group continued to decrease (P < 0.01). After 7 days of treatment, FDP and D-Dimer (DD) in the Xuebijing group were lower than those in the control group (P < 0.01), and clot formation time was significantly shortened; α angle, maximum clot strength (MA), and coagulation index (CI) were significantly increased, and all were better than those in the control group (P < 0.05). There was no statistically significant difference in these indicators before and after treatment in the control group (P > 0.05). After 7 days of treatment, APACH Ⅱ scores in both groups decreased compared to before treatment (P < 0.05), but the performance of the Xuebijing group was better (P < 0.05). The 28-day fatality rate in the Xuebijing group was 17.95%, lower than that in the control group at 23.08%.
      Conclusions  Combined with routine symptomatic treatment, Xuebijing injection could effectively improve the coagulation function of sepsis patients, showing a positive role in the treatment of sepsis patients.

     

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