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目的:探讨前列腺素E1联合血必净对脓毒症患者炎症反应进程及靶器官功能的影响。方法:选择2014年2月~2017年7月本院接受治疗的脓毒症患者78例,经随机数表法分为对照组、研究组,各39例。对照组患者在常规治疗基础上加入血必净治疗,研究组患者在常规治疗基础上加入前列腺素E1联合血必净治疗。对比两组患者治疗前(T0)、治疗1周后(T1)、治疗2周后(T2)血清中炎症介质及靶器官功能指标含量的差异。结果:T0时,两组患者血清中炎症介质、心肌酶谱指标、肝肾功能指标含量的差异无统计学意义(P>0.05)。T1、T2时,研究组患者血清中炎症介质白介素(IL)-6、IL-10、降钙素原(PCT)、C反应蛋白(CRP)含量低于对照组患者;血清中心肌酶谱指标肌酸激酶同工酶(CK-MB)、高敏心肌肌钙蛋白(hs-cTnT)、乳酸脱氢酶(LDH)含量低于对照组患者;血清中肝肾功能指标尿素氮(BUN)、血肌酐(Cr)、总胆红素(TBIL)、总胆汁酸(TBA)含量低于对照组患者。差异均有统计学意义(P<0.05)。结论:脓毒症患者接受前列腺素E1联合血必净治疗,可有效减轻患者的全身炎症反应并积极保护肝肾功能。
Abstract：Objective:To explore the effect of prostaglandin E1 combined with Xuebijing on the inflammatory response process and target organ function in patients with sepsis.Methods:78 patients with sepsis patients who were treated in our hospital between February 2014 and July 2017 were divided into control group(n=39)and study group(n=39)by random number table method.Control group received Xuebijing therapy on the basis of routine treatment,and study group received prostaglandin E1 combined with Xuebijing therapy on the basis of routine treatment.The differences in serum levels of inflammatory mediators and target organ function indexes were compared between the two groups before treatment(T0),after 1 week of treatment(T1)and after 2 weeks of treatment(T2).Results:At T0,there was no statistically significant difference in the serum levels of inflammatory mediators,myocardial enzyme spectrum indexes as well as liver and kidney function indexes between the two groups.At T1 and T2,serum inflammatory mediators IL-6,IL-10,PCT and CRP levels of study group were lower than those of control group;serum myocardial enzyme spectrum indexes CK-MB,hs-cTnT and LDH contents were lower than those of control group;serum liver and kidney function indexes BUN,Cr,TBIL and TBA contents were lower than those of control group.Conclusion:prostaglandin E1 combined with Xuebijing can effectively reduce the systemic inflammatory response and actively protect the liver and kidney function of patients with sepsis.
1 Agarwal A,Agarwal A.Infection associated secondary hemophagocytic lymphohistiocytosis in sepsis syndromes-A tip of an iceberg[J].J Assoc Physicians India,2017,65(10):44-50.
2 Singh H,Ramai D,Patel H,et al.B-type natriuretic peptide:a predictor for mortality,intensive care unit length of stay,and hospital length of stay in patients with resolving sepsis[J].Cardiol Res,2017,8(6):271-275.
3 Dalli J,Colas RA,Quintana C,et al.Human sepsis eicosanoid and proresolving lipid mediator temporal profiles:correlations with survival and clinical outcomes[J].Crit Care Med,2017,45(1):58-68.
4 Willenberg I,Rund K,Rong S,et al.Characterization of changes in plasma and tissue oxylipin levels in LPS and CLP induced murine sepsis[J].Inflamm Res,2016,65(2):133-142.
5 Boivin A,Burban M,Clere-Jehl R,et al.Docosahexaenoic acid,but not eicosapentaenoic acid,improves septic shock-induced arterial dysfunction in rats[J].PLoS One,2017,12(12):e0189658.
6 Lopes Pires ME,Clarke SR,Marcondes S,et al.Lipopolysaccharide potentiates platelet responses via toll-like receptor 4-stimulated Akt-Erk-PLA2signalling[J].PLoS One,2017,12(11):e0186981.
7 Blaschke U,Beineke A,Klemens J,et al.Induction of cyclooxygenase 2by streptococcus pyogenes is mediated by cytolysins[J].J Innate Immun,2017,9(6):587-597.
8 Qiu G,Zheng G,Ge M,et al.Adipose-derived mesenchymal stem cells modulate CD14++CD16+expression on monocytes from sepsis patients in vitro via prostaglandin E2[J].Stem Cell Res Ther,2017,8(1):97.
9 Giustina AD,Bonfante S,Zarbato GF,et al.Dimethyl fumarate modulates oxidative stress and inflammation in organs after sepsis in rats[J].Inflammation,2018,41(1):315-327.
10 Lu Y,Yang Y,He X,et al.Esmolol reduces apoptosis and inflammation in early sepsis rats with abdominal infection[J].Am J Emerg Med,2017,35(10):1480-1484.
11 VirzìGM,Clementi A,Brocca A,et al.Cardiorenal syndrome type 5in sepsis:role of endotoxin in cell death pathways and inflammation[J].Kidney Blood Press Res,2016,41(6):1008-1015.
12 Lobo LA,Benjamim CF,Oliveira AC.The interplay between microbiota and inflammation:lessons from peritonitis and sepsis[J].Clin Transl Immunology,2016,5(7):e90.
13 Mertens K,Lowes DA,Webster NR,et al.Low zinc and selenium concentrations in sepsis are associated with oxidative damage and inflammation[J].Br J Anaesth,2015,114(6):990-999.
14 Wang Y,Braun O,Zhang S,et al.Monocytes regulate systemic coagulation and inflammation in abdominal sepsis[J].Am J Physiol Heart Circ Physiol,2015,308(5):H540-H547.
15 Unuma K,Aki T,Nagano S,et al.The down-regulation of cardiac contractile proteins underlies myocardial depression during sepsis and is mitigated by carbon monoxide[J].Biochem Biophys Res Commun,2018,495(2):1668-1674.
16 Kawaguchi R,Hirata N,Tokinaga Y,et al.Nitrite administration improves sepsis-induced myocardial and mitochondrial dysfunction by modulating stress signal responses[J].J Anesth,2017,31(6):885-894.
17 Li X,Cheng Q,Li J,et al.Significance of hydrogen sulfide in sepsis-induced myocardial injury in rats[J].Exp Ther Med,2017,14(3):2153-2161.
18 Clancy DJ,Slama M,Huang S,et al.Detecting impaired myocardial relaxation in sepsis with a novel tissue Doppler parameter(septal e'/s')[J].Crit Care,2017,21(1):175.
19 Kaulen SA,Hübner C,Mieth J,et al.Indocyanine green elimination for the evaluation of liver function:prognostic value in patients with community-acquired sepsis[J].Med Klin Intensivmed Notfmed,2014,109(7):531-540.
20 Chung HY,Witt CJ,Jbeily N,et al.Acid sphingomyelinase inhibition prevents development of sepsis sequelae in the murine liver[J].Sci Rep,2017,7(1):12348.
21 Dong W,Li Z,Chen Y,et al.Necrostatin-1attenuates sepsisassociated acute kidney injury by promoting autophagosome elimination in renal tubular epithelial cells[J].Mol Med Rep,2018,17(2):3194-3199.
22 Lara B,Enberg L,Ortega M,et al.Capillary refill time during fluid resuscitation in patients with sepsis-related hyperlactatemia at the emergency department is related to mortality[J].PLoS One,2017,12(11):e0188548.
基本信息:
DOI：10.13210/j.cnki.jhmu.20180125.007
中图分类号:R459.7
引用信息:
[1]汪毓君,喻莉.前列腺素E1联合血必净对脓毒症患者炎症反应进程及靶器官功能的影响[J].海南医学院学报,2018,24(04):537-540.DOI:10.13210/j.cnki.jhmu.20180125.007.
基金信息:
武汉市卫生局科研项目(wx12c35)~~
2018-01-25
2018-01-25
2018-01-25