血必净对重症脓毒症和脓毒症休克时 BNP、TnT 及TnI水平的影响

目的：研究血必净对重症脓毒症和脓毒症休克时BNP、TnT及TnI水平的影响。方法选取收治的78例重症脓毒症和脓毒症休克患者，分为试验组和对照组，每组39例。对照组为常规治疗加0鲻．9％氯化钠溶液100 ml进行治疗，试验组为常规治疗加血必净注射液100 ml进行治疗。比较2组患者治疗前和治疗后7 d脑利钠肽（ BNP）、肌酐蛋白T（ TnT）及肌酐蛋白I（ TnI）水平及炎性因子变化，评价患者不同时间点APACHEⅡ评分。结果治疗后，试验组BNP、TnT及TnI水平明显低于对照组（484．32±24．03） ng／L、（571．23±29．14） ng／L，（580．65±36．64） ng／L、（657．53±43．24）ng／L，（543．53±41．03）ng／L、（663．46±45．67）ng／L]，差异有统计学意义（ P ＜0．05）。试验组治疗后肿瘤坏死因子-α（TNF-α）、白介素-6（IL-6）及降钙素原（PCT）炎性因子水平明显低于对照组（38．43±3．21）pg／ml、（53．54±4．05）pg／ml，（385．24±38．05）pg／ml、（495．24±45．78）pg／ml，（2．56±0．24）ng／ml、（3．86±0．53）ng／ml]，差异有统计学意义（ P ＜0．05）。试验组机械通气时间、住院时间明显短于对照组（7．43±0．87）d、（9．53±1．41）d，（12．35±1．34）d、（18．95±1．87）d]（P＜0．05）。试验组治疗后7 d APACHEⅡ评分明显低于对照组（14．56±1．32）分、（16．32±1．84）分]（ P ＜0．05）。结论血必净能有效降低重症脓毒症和脓毒症休克时的BNP、TnT、TnI水平，临床疗效良好。

Effects of Xuebijing injection on the levels of BNP,TnT and TnI in patients with severe sepsis and sepsis shock

Objective To observe the effects of Xuebijing on the levels of brain natriuretic peptide ( BNP ) , creatinine protein T ( TnT) and creatinine protein I ( TnI) in patients with severe sepsis and sepsis shock.Methods Seventy-eight patients with severe sepsis and sepsis shock who were admitted and treated in our hospital were divided into:trial group and control group,with 39 patients in each group.The patients in control group were treated by conventional treatment+09%sodium chloride solution 100ml, however, the patients in trial group were treated by conventional treatment+ Xuebijing injection .The levels of BNP, TnT, TnI and inflammatory cytokines before treatment and on 7 days after treatment were detected and compared between two groups.Results After treatment, the levels of BNP, TnT and TnI in trial group were significantly lower than those in control group(484.32 ±24.03)ng/L vs (571.23 ±29.14)ng/L, (580.65 ±36.64)ng/L vs (657.53 ±43.24)ng/L,(543.53 ±41.03)ng/L vs (663.46 ±45.67)ng/L,respectively]( P <0.05).After treatment, the levels of tumor necrosis factor alpha (TNF-alpha),interleukin 6 (IL-6) and calcitonin (PCT) in trial group were significantly lower than those in control group(38.43 ±3.21)pg/ml vs (53.54 ±4.05)pg/ml,(385.24 ±38.05)pg/ml vs (495.24 ± 45.78)pg/ml, (2.56 ±0.24)ng/ml vs (3.8 ±0.53)ng/ml, respectively]( P <0.05).Moreover the mechanical ventilation time and hospitalization time in trial group were significantly shorter than those in control group (7.43 ±0.87) d vs (9.53 ± 1.41)d, (12.35 ±1.34)d vs (18.95 ±1.87)d,respectively]( P <0.05).After 7-day treatment,the APACHEⅡscores in trial group were significantly lower than those in control group(14.56 ±1.32) points vs (16.32 ±1.84)]( P <0.05). Conclusion Xuebijing injection can effectively decrease the levels of BNP, TnT and TnI in patients with severe sepsis and sepsis shock,with better therapeutic effects.