帕瑞昔布钠对腹腔感染所致脓毒症患者肠屏障功能的影响

目的探析帕瑞昔布钠对腹腔感染所致脓毒症患者炎性因子的影响及对肠屏障功能的保护作用。方法分析2015年4月至2017年10月在南京中医药大学附属南京市中西医结合医院接受诊治的97例腹腔感染所致脓毒症患者的临床资料,根据随机数字表法将入选患者分成治疗组(帕瑞昔布钠,50例)与对照组(生理盐水,47例)。比较两组患者的基线资料、治疗前后的肠型脂肪酸结合蛋白(I?fatty acid?binding protein,I?FABP)、二胺氧化酶(diamine oxidase,DAO)、D?乳酸(D?lactate,D?Lac)、IL?6、C反应蛋白(C reactive protein,CRP)、TNF?α水平以及治疗后的病死率。结果两组患者的基线资料差异无统计学意义(P>0.05)。治疗前两组患者肠屏障功能、炎性指标差异均无统计学意义(P>0.05);治疗后两组患者的肠屏障功能指标I?FABP、DAO、D?Lac水平均明显低于同组治疗前,且治疗组患者的I?FABP、DAO及D?Lac水平明显低于对照组(P<0.05);治疗后两组患者的炎性指标IL?6、CRP及TNF?α水平均明显低于治疗前,且治疗组的IL?6、CRP及TNF?α水平均明显低于对照组(P<0.05)。患者28 d内病死率治疗组(12.0%,6/50)明显低于对照组(31.9%,14/47)(χ^2=4.683,P=0.03)。结论帕瑞昔布钠在缓解脓毒症患者炎症反应的同时还可以保护肠屏障功能,且安全性良好。

Effects of parecoxib sodium on the intestinal barrier function of septic patients induced by abdominal infection

Objective To explore the effects of parecoxib sodium on the inflammatory factors of septic patients induced by abdominal infection and the function of intestinal barrier.Methods Clinical data were collected from 97 septic patients who were admitted into Nanjing Integrated Traditional Chinese and Western Medicine Hospital due to abdominal infection and received treatment from April,2015 to October,2017.According to the random number table method,the patients were divided into two groups:a treatment group(parecoxib,n=50)and a control group(normal saline,n=47).Both groups were compared for general information,I?fatty acid?binding protein(I?FABP),diamine oxidase(DAO),D?lactate(D?Lac),interleukin?6(IL?6),C reactive protein(CRP)and tumor necrosis factor?α(TNF?α)before and after treatment,and morality after treatment.Results There was no statistical difference in general information between the two groups(P>0.05).No statistical difference was found in intestinal barrier function and inflammatory indicators in both groups before treatment(P>0.05).The two groups presented remarkably reduced levels of I?FABP,DAO and D?Lac after treatment,compared with their levels before treatment,and the levels of I?FABP,DAO and D?Lac in the treatment group were obviously lower than those in the control group(P<0.05).The two groups presented remarkably reduced levels of IL?6,CRP and TNF?αafter treatment,compared with their levels before treatment,and the levels of IL?6,CRP and TNF?αin the treatment group were obviously lower than those in the control group(P<0.05).The 28?day mortality of the treatment group(12.0%,6/50)was obviously lower than that of the control group(31.9%,14/47)(χ^2=4.683,P=0.03).Conclusions Parecoxib sodium can relieve inflammatory reaction,while protecting the intestinal barrier function in septic patients,with good safety.