血必净注射液治疗重症肺炎的临床疗效观察

摘要

目的：观察血必净注射液治疗重症肺炎患者的临床疗效。方法选取2014年8月—2015年10月解放军第474医院收治的重症肺炎患者97例，根据治疗方式不同分为常规治疗组45例和联合治疗组52例。常规治疗组患者采用常规治疗方案以及对症治疗，联合治疗组患者常规治疗组基础上给予血必净注射液；两组患者均连续治疗2周。比较两组患者临床疗效、治疗前后肺功能指标及血清炎性因子水平、不良反应发生情况。结果联合治疗组患者临床疗效优于常规治疗组（P <0.05）。治疗前，两组患者6分钟步行距离（6MWD）、用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、FEV1/ FVC、最大呼气中期流速（MMEF）及最高呼气流速（PEF）比较，差异无统计学意义（ P >0.05）；治疗后联合治疗组患者6MWD 长于常规治疗组，FVC、FEV1、FEV1/ FVC、MMEF 及 PEF 均高于常规治疗组（P <0.05）。治疗前两组患者血清白介素6（IL-6）、超敏 C 反应蛋白（hs-CRP）和肿瘤坏死因子α（TNF-α）水平比较，差异无统计学意义（P >0.05）；治疗后，联合治疗组患者血清 IL-6、hs-CRP和 TNF-α水平低于常规治疗组（P <0.05）。两组患者治疗期间均未发生明显肝肾功能损伤，联合治疗组仅有1例患者出现胃肠道反应。结论血必净注射液治疗重症肺炎的临床疗效确切，可有效改善患者肺功能，降低血清炎性因子水平，且安全性较高。%Objective To observe the clinical effect of xuebijing injection on severe pneumonia. Methods A total of 97 patients with severe pneumonia were selected in the 474th Hospital of Chinese People′s Liberation Army from August 2014 to October 2015,and they were divided into A group(n = 45)and B group(n = 52)according to therapeutic methods. Patients of A group received conventional treatment and symptomatic treatment,while patients of B group received extra xuebijing injection based on that of A group;both groups continuously treated for 2 weeks. Clinical effect,index of pulmonary function and serum inflammatory cytokines levels before and after treatment,and incidence of adverse reactions were compared between the two groups. Results The clinical effect of B group was statistically significantly better than that of A group( P < 0. 05). No statistically significant differences of 6 - minute walk distance,FVC,FEV1 ,FEV1 / FVC,MMEF or PEF was found between the two groups before treatment( P > 0. 05);after treatment,6 - minute walk distance of B group was statistically significantly longer than that of A group,while FVC,FEV1 ,FEV1 / FVC,MMEF and PEF of B group were statistically significantly higher than those of A group(P < 0. 05). No statistically significant differences of serum level of IL-6,hs-CRP or TNF-α was found between the two groups before treatment( P > 0. 05 ),while serum levels of IL-6,hs-CRP and TNF-α of B group were statistically significantly lower than those of A group after treatment(P < 0. 05). No one of the two groups occurred any obvious liver or kidney function damage during the treatment,but one of B group occurred gastrointestinal reaction. Conclusion Xuebijing injection has certain clinical effect in treating severe pneumonia,can effectively improve the pulmonary function and reduce the serum inflammatory cytokines levels,and is relatively safe.