【摘要】 目的 分析血必净注射液和低分子肝素钙在脓毒症治疗中的应用。方法 选取2021年11月—2024年11月在连云港市第二人民医院治疗的82例脓毒症患者，按照分层随机抽样法将患者分为对照组（低分子肝素钙治疗，41例）和试验组（血必净注射液联合低分子肝素钙治疗，41例）。对比两组疗效状况、凝血功能[D-二聚体（D-D）、纤维蛋白原（FIB）]、血栓弹力图相关指标[反应时间（R时间）、凝固时间（K时间）、α角、最大血块强度（MA）值、CI-综合凝血指数）]、炎症因子[降钙素原（PCT）、白细胞介素（IL）-6、C反应蛋白（CRP）]、T淋巴细胞亚群（CD3~+、CD4~+、CD8~+、CD4~+/CD8~+）、全身感染相关性器官功能衰竭（SOFA）评分、急诊科脓毒症相关死亡率评分（MEDS）、急性生理与慢性健康状况Ⅱ（APACHEⅡ）评分的差异。结果 试验组的总有效率高于对照组（P<0.05）；试验组治疗后D-D水平低于对照组，FIB水平高于对照组（P<0.05）；试验组治疗前后D-D、FIB的差值均大于对照组（P<0.05）。试验组治疗后K时间短于对照组，α角、MA值、CI值均高于对照组（P<0.05）；试验组治疗前后K时间、α角、MA值、CI值的差值均大于对照组（P<0.05）。试验组治疗后PCT、IL-6、CRP水平低于对照组（P<0.05）；试验组治疗前后PCT、IL-6、CRP的差值均大于对照组（P<0.05）。试验组治疗后CD3~+、CD4~+、CD4~+/CD8~+高于对照组，CD8~+低于对照组（P<0.05）；试验组治疗前后CD3~+、CD4~+、CD8~+、CD4~+/CD8~+的差值均大于对照组（P<0.05）。试验组治疗后SOFA评分、MEDS评分、APACHEⅡ评分低于对照组（P<0.05）；试验组治疗前后SOFA评分、MEDS评分、APACHEⅡ评分的差值均大于对照组（P<0.05）。结论 血必净注射液联合低分子肝素钙治疗脓毒症可以有效优化患者的凝血功能，改善血栓弹力图相关指标，调节炎症反应，并提升免疫水平，显著降低SOFA评分、MEDS评分和APACHEⅡ评分，具有较好的临床应用效果。更多还原

【Abstract】 Objective To analyze the application of Xuebijing Injection and low molecular weight heparin calcium in the treatment of sepsis. Methods A total of 82 patients with sepsis who were treated at Lianyungang Second People’s Hospital from November 2021 to November 2024 were selected. The patients were divided using the stratified random sampling method into the control group(treated with low molecular weight heparin calcium, n = 41) and the experimental group(treated with Xuebi Jing injection in combination with low molecular weight heparin calcium, n = 41). The efficacy, coagulation function [D-dimer(D-D), fibrinogen(FIB) ], thromboelastography(TEG) parameters [R time(reaction time), K time(clot formation time), α angle(α angle), MA value(maximum amplitude), CI value(coagulation index) ], inflammatory factors [procalcitonin(PCT), interleukin-6(IL-6), Creactive protein(CRP) ], T lymphocyte subsets(CD3~+, CD4~+, CD8~+, CD4~+/CD8~+), sepsis-related organ failure assessment(SOFA score), mortality in emergency department sepsis(MEDS) score, and acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ score) were compared between the two groups. Results The total effective rate in the experimental group was higher than in the control group(P < 0.05). After treatment, the experimental group had lower D-D levels and higher FIB levels compared to the control group(P < 0.05). The changes in D-D and FIB levels before and after treatment were significantly greater in the experimental group than in the control group(P < 0.05). After treatment, the experimental group had shorter K time, and higher α angle, MA value, and CI value compared to the control group(P < 0.05). The changes in K time, α angle, MA value, and CI value before and after treatment were significantly greater in the experimental group than in the control group(P < 0.05). After treatment, the experimental group had lower PCT, IL-6, and CRP levels compared to the control group(P < 0.05). The changes in PCT, IL-6, and CRP levels before and after treatment were significantly greater in the experimental group than in the control group(P < 0.05). After treatment, the experimental group had higher CD3~+, CD4~+, and CD4~+/CD8~+ levels, and lower CD8~+ levels compared to the control group(P < 0.05). The changes in CD3~+, CD4~+, CD8~+, and CD4~+/CD8~+ levels before and after treatment were significantly greater in the experimental group than in the control group(P < 0.05). After treatment, the experimental group had lower SOFA, MEDS, and APACHE Ⅱ scores compared to the control group(P < 0.05). The changes in SOFA, MEDS, and APACHE Ⅱ scores before and after treatment were significantly greater in the experimental group than in the control group(P < 0.05). Conclusion The use of Xuebijing injection in combination with low molecular weight heparin calcium for the treatment of sepsis can effectively optimize the coagulation function of patients, improve the relevant indicators of thromboelastography, regulate the inflammatory response, and enhance the immune level. It significantly reduces the SOFA score, MEDS score and APACHE Ⅱ score, and has a good clinical application effect.更多还原