CAJ | 학술논문

目的：观察血必净注射液治疗脓毒症合并急性肾损伤(Sepsis acute kidney injury，SAKI)效果，并探讨其对患者血浆内白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)含量的影响。方法选择2011年9月至2013年3月我院诊治的SAKI患者40例，按随机数字法分为观察组和对照组各20例。对照组用一般药物进行治疗，观察组则在对照组治疗的基础上增加每天血必净注射液80 ml，疗程15 d。治疗前后根据RIFLE分级标准记录患者的RIFLE等级，比较其病情恢复和恶化程度。观察两组患者C-反应蛋白(CRP)、外周血T淋巴细胞亚群(CD3+，CD4+)、白细胞数量(WBC)、IL-6水平以及TNF-α水平前后变化。结果根据RIFLE分级，观察组和对照组治疗前的CRP、CD3+、CD4+、IL-6、TNF-α、WBC比较差异均无统计学意义(P>0.05)。治疗后观察组的IL-6、TNF-α、WBC较对照组水平均明显降低(P<0.05)，而观察组的CD3+、CD4+含量较对照组明显升高(P<0.05)。观察组治疗的有效率为85.00%(17/20)，对照组为25.00%(5/20)，其差异有统计学意义(P<0.05)。结论血必净注射液能够有效控制血浆内炎性因子的作用，使SAKI患者的免疫系统得到调节，相比平常药物能更显著地改善SAKI症状。
목적：관찰혈필정주사액치료농독증합병급성신손상(Sepsis acute kidney injury，SAKI)효과，병탐토기대환자혈장내백세포개소-6(IL-6)화종류배사인자-α(TNF-α)함량적영향。방법선택2011년9월지2013년3월아원진치적SAKI환자40례，안수궤수자법분위관찰조화대조조각20례。대조조용일반약물진행치료，관찰조칙재대조조치료적기출상증가매천혈필정주사액80 ml，료정15 d。치료전후근거RIFLE분급표준기록환자적RIFLE등급，비교기병정회복화악화정도。관찰량조환자C-반응단백(CRP)、외주혈T림파세포아군(CD3+，CD4+)、백세포수량(WBC)、IL-6수평이급TNF-α수평전후변화。결과근거RIFLE분급，관찰조화대조조치료전적CRP、CD3+、CD4+、IL-6、TNF-α、WBC비교차이균무통계학의의(P>0.05)。치료후관찰조적IL-6、TNF-α、WBC교대조조수평균명현강저(P<0.05)，이관찰조적CD3+、CD4+함량교대조조명현승고(P<0.05)。관찰조치료적유효솔위85.00%(17/20)，대조조위25.00%(5/20)，기차이유통계학의의(P<0.05)。결론혈필정주사액능구유효공제혈장내염성인자적작용，사SAKI환자적면역계통득도조절，상비평상약물능경현저지개선SAKI증상。
Objective To explore the effect of Xuebijing injection in the treatment of sepsis acute kidney in-jury (SAKI), and the influence on plasma interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) level in pa-tients. Methods Forty patients with sepsis acute kidney injury in our hospital from September 2011 to March 2013 were selected, which were divided into observation group (n=20) and control group (n=20) randomly. The patients in control group received routine treatment, while the patients in observation group received routine treatment and Xue-bijing injection 80 ml every day. The treatment lasted for 15 days. Patients' RIFLE grades were recorded according to RIFLE grading standard before and after the treatment. The recovery and the degree of deterioration were com-pared. The C-reactive protein (CRP), peripheral blood T lymphocyte subsets (CD3+, CD4+), white blood cell count (WBC), the IL-6 level and the TNF-αlevel of patients in two groups were compared before and after the treatment. Results According to RIFLE classification, before treatment, there were no statistical significance in the CRP, CD3+, CD4+, IL-6, TNF-α, WBC between patients in observation group and control group(P>0.05). After treatment, the CRP, IL-6, TNF-α, WBC of patients in observation group decreased significantly compared to that of the control group and the CD3+, CD4+of patients in the control group increased significantly(P<0.05). The effective rate of treatment in observation group was 85%(17/20), which was significantly higher than that in control group [25%(5/20)], P<0.05. Conclusion Xuebijing injection can effectively control the effects of plasma inflammatory factors and improve the immune functions in SAKI patients. It can improve the symptoms of SAKI better than conventional therapy.