【摘要】 目的探讨血必净治疗脓毒症的疗效及对血小板内皮细胞黏附分子-1(PE-CAM-1)血清浓度和凝血功能的影响。方法将44例脓毒症患者随机分成血必净组11例和对照组33例。对照组给予常规的抗感染、脏器保护、对症支持治疗;血必净组在对照组基础上给予血必净注射液100 mL/d静滴,共7～10 d。统计2组14 d存活率,并于患者入院后24 h、48 h、72 h、7 d、14 d分别检测血清PECAM-1水平、血小板计数及凝血酶原时间(PT)、部分凝血活酶时间(APTT)和D-二聚体水平。结果血必净组14 d存活率(91%)明显高于对照组(70%)。血清PECAM-1水平,对照组治疗前48 h呈上升趋势,48 h达到高峰,紧接着下降并趋于平稳,治疗后2周回到治疗前水平;而血必净组48 h明显下降,而后逐渐上升并趋于平稳,治疗后2周回到治疗前水平。2组血小板计数和D-二聚体变化比较无显著性差异,而血必净组PT和APTT在每一个时间段均低于对照组。结论血必净治疗脓毒症可以明显改善预后,其机制可能与改变PECAM-1的血清浓度变化以及改善凝血功能有关。更多还原

【Abstract】 Objective: It is to explore the curative effect of Xuebijin on sepsis and its influence on the serum concentration of PECAM-1 and the coagulation function.Methods 44 patients with sepsis were randomly divided into 2 groups,of which 33 cases were enrolled as control group,who were treated with such traditional medicine as antibiotics,medicine for organ protection,allopathic and supporting medicine for 7 to 10 days,and 11 cases as Xuebijing injection group(Group IT),who were treated with the same medicine as control group and XueBiJing injection for the same period of treatment.The survival rate of 14 days were calculated,the serum concentration of PECAM-1,thrombocyte count and coagulation function(e.g.PT,APTT and D-dimer) on 24th hour,48th hour,72nd hour,7th day and 14th day were also determined.Results The survival rate of 14 days in Group IT(91%) was significantly higher than that of control group(70%).The changes of serum concentration of PECAM-1 in the two groups was as the follows: the concentration of the control group began to increase at 48h before treatmetn,and reached it’s climax in the first 48 hours,then descended to a stable level and reached its primary level in 2 weeks after treatment,while that of Group IT decreased in the first 48 hours,then ascended to a stable level until it reached another peak,and reached its primary level in 2 weeks after treatment.The thrombocyte count and D-dimer showed no remarkable differences between the two groups,while PT and APTT in group IT were all lower than that in the control group at every time stage.Conclusion Xuebinjin can effectively improve the prognosis of sepsis patient,and the mechanism may be that it can change the PECAM-1 serum concentration and improve the coagulation function.更多还原