前列腺素E1对脓毒症患者疗效及炎症水平的影响

目的 探讨联合使用前列腺素E1对脓毒症患者的疗效,以及对促炎及抗炎因子水平的影响.方法 将该院ICU的脓毒症患者120例分为A、B、C、D4组,每组30倒.在常规治疗基础上,A组加用前列腺素E1和血必净注射液,B组加用前列腺素E1,C组加用血必净注射液,D组只采用常规治疗.对比观察4组患者急性生理和慢性健康状况评分Ⅱ(APACHEⅡ)及Marshall评分、抗炎及促炎因子、机械通气时间、ICU治疗时间、28 d病死率等变化.结果 与治疗前比较,4组患者治疗后A-PACHEⅡ及Marshall评分均明显降低(P＜0.05).与B、C、D组比较,A组治疗后APACHEⅡ及Marshall评分、IL-1β、IL-6及TNF-α水平降低更明显(P＜0.05),IL-10水平明显升高(P＜0.05);机械通气时间、ICU住院时间明显较短(P＜0.05),28 d病死率明显较低(P＜0.05).结论 前列腺素E1联合血必净注射液能有效抑制脓毒症患者体内炎性反应,促进患者恢复,降低病死亡率.

Efficacy of prostaglandin E1 in sepsis patients and its influence on inflammatory level

Objective To investigate the effects of prostaglandin E1 on proinflammatory and anti-inflammatory cytokines in sepsis patients.Methods One hundred and twenty cases of sepsis in ICU of our hospital were assigned to the groups:A,B,C and D,30 cases in each group.On the basis of conventional therapy,group A was added with prostaglandin El+ Xuebijing injection.The group was treated with prostaglandin E1,while the group C was treated with Xuebijing injection.The changes of APACHE Ⅱ score,Marshall score,anti-inflammatory and pro-inflammatory factors,mechanical ventilation time,ICU treatment time,28 d mortality rate in the 4 grups were observed and compared among 4 groups.Results The APACHE Ⅱ score and Marshall score after treatment in 4 groups were significantly decreased compared with before freatment (P＜0.05),Compared with the group B,C and D,The decrease of APACHE Ⅱ score,Marshace score,IL-1β,IL-6 and TNF-α levels was more significantly(P＜0.05),While the IL-10 level was significantly increastol(P＜0.05);duration of mechanical ventilation,length of stay ICU in were significantly shorter (P＜0.05),28 d mortality was significantly lower (P＜0.05).Conclusion Prostaglandin E1 combined with Xuebijing injection can effectively inhibit the inflammatory response in septic patients and promote the recovery of patients,reduces the mortality rate.