CAJ | 학술논문

目的探讨复方丹参注射液对急性肺损伤(ALI)患者血清血小板活化因子(PAF)表达及凝血系统功能的影响.方法 ALI患者40例,随机分为对照组和治疗组,每组各20例,对照组予以治疗原发病、机械通气、激素治疗、抗感染、维持水电解质及酸碱平衡等常规治疗.治疗组在常规治疗的基础上加用复方丹参注射液20 mL溶于5%葡萄糖注射液250 mL中静脉滴注,1次/d,共3 d.分别于治疗前及治疗3 d后测定血清PAF、血栓素B_2(TXB_2)和凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、血小板参数及血气分析.比较对照组和治疗组治疗前后血清PAF、TXB_2和PT、APTT、FIB、血小板参数及血气分析变化.结果与治疗前比较,治疗后两组氧合均改善,PAF和TXB_2下降,PT、APTT延长,FIB下降,血小板参数改善(均P<0.01).与对照组比较,治疗组治疗后氧合显著改善,PAF和TXB_2显著下降,PT、APTT显著延长,FIB显著升高,血小板参数显著改善(P<0.01或P<0.05).但两组病死率比较差异无统计学意义(P>0.05).结论复方丹参能减少ALI患者PAF的表达,改善ALI患者高凝状态和氧合,为临床早期治疗ALI提供了新方法.
목적 탐토복방단삼주사액대급성폐손상(ALI)환자혈청혈소판활화인자(PAF)표체급응혈계통공능적영향.방법 ALI환자40례,수궤분위대조조화치료조,매조각20례,대조조여이치료원발병、궤계통기、격소치료、항감염、유지수전해질급산감평형등상규치료.치료조재상규치료적기출상가용복방단삼주사액20 mL용우5%포도당주사액250 mL중정맥적주,1차/d,공3 d.분별우치료전급치료3 d후측정혈청PAF、혈전소B_2(TXB_2)화응혈매원시간(PT)、활화부분응혈활매시간(APTT)、섬유단백원(FIB)、혈소판삼수급혈기분석.비교대조조화치료조치료전후혈청PAF、TXB_2화PT、APTT、FIB、혈소판삼수급혈기분석변화.결과 여치료전비교,치료후량조양합균개선,PAF화TXB_2하강,PT、APTT연장,FIB하강,혈소판삼수개선(균P<0.01).여대조조비교,치료조치료후양합현저개선,PAF화TXB_2현저하강,PT、APTT현저연장,FIB현저승고,혈소판삼수현저개선(P<0.01혹P<0.05).단량조병사솔비교차이무통계학의의(P>0.05).결론 복방단삼능감소ALI환자PAF적표체,개선ALI환자고응상태화양합,위림상조기치료ALI제공료신방법.
Objective To investigate the effects of compound salvia miitiorrhiza parenteral solution on PAF expression and blood coagulation function in ALI patients.Methods 40 patients of ALI were randomly divided into two groups: control group (20 cases) and treatment group (20 cases).The basic treatments of two groups included primary disease treatment, anti -infection, keeping the balance of water -electrolyte, adrenal corticalhormone treatment and mechanical ventilation.The treatment group was supernumerarily injected with compound salvia miltiorrhiza parenteral solution 20mL and 5% glucose solution injection 250mL for 3d.Serum PAF and thromboxane B_2(TXB_2) level, prothrombin time (PT), activated partial thromboplastin time (APTT), fibrin (Fib), parameter of blood platelets and blood gas analysis were measured before the treatment and 3 days after the treatment.PAF and TXB_2, PT, APTT, parameter of blood platelets and blood gas analysis of two groups were compared before and after the treatment.Results Compared with those before the treatment, the oxygenation were improved, PAF and TXB_2 level decreased, PT and APTT increased, Fib decreased and parameter of blood platelets improved in both groups after the treatment(P <0.01).Compared with control group, the oxygenation were improved, PAF and TXB_2 level decreased, PT and APTT increased, Fib increased and parameter of blood platelets improved in treatment group.however, the mortality between two groupshad no significant difference (P > 0.05).Conclusion Compound salvia miltiorrhiza parenteral solution could decrease the expression of serum PAF in ALI patients.It could also improve coagulation function of ALI and oxygenation.So, it could be a new approach for early clinical treatment of ALI.