血必净对毛细血管渗漏综合征患者血管内皮细胞的作用

摘要

目的：观察血必净注射液对毛细血管渗漏综合征(CLS)患者血管内皮细胞的保护作用及临床疗效。方法将 CLS 患者59例随机分为对照组和血必净组，在相同的常规治疗基础上，血必净组加用血必净注射液100 ml 静脉滴注。选择健康查体者30例作为正常组，两组患者均在入院时及治疗第2、5、7天检测外周血循环内皮细胞(CEC)及尿微量白蛋白(MAU)。结果①入院时两组患者 CEC 和 MAU 均高于正常组(P <0.01)。血必净组和对照组在治疗第2、5、7天 CEC、MAU 含量逐渐下降(P <0.05或<0.01)；②血必净组治疗后第7天急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)评分、多器官功能障碍综合征(MODS)发生率和28天病死率均显著低于对照组(均 P <0.01)；③MAU 与 CEC、APACHEⅡ评分、MODS 发生率及28天病死率均呈正相关(均 P <0.01)。结论血必净注射液对 CLS 患者血管内皮细胞有保护作用，有良好的临床疗效。MAU 是早期反映 CLS 患者血管内皮损伤和病情严重程度的良好指标。%Objective To observe the protective effect on vascular endothelium and clinical efficacy of Xuebijing in patients with capillary leak syndrome(CLS).Methods A total of 59 CLS patients were divided randomly into two groups:control group and Xuebijing group.Both groups received routine treatment.In Xuebijing group,patients were treated with intravenous Xuebijing injection 100 ml,q 12 h,for 7 days.Normal group included 30 healthy controls of outpatients at corresponding period.Circulating endothelial cell (CEC)and microalbuminuria (MAU)were measured in all patients on admission to hospital and on the 2nd,5th,7th days,respectively.Results ① CEC and MAU were markedly higher in both groups than in normal group on admission to hospital (P < 0.01 ).CEC and MAU in Xuebijing group and control group decreased gradually on the 2nd,5th and 7th day,with statistically significant differences (P <0.05 and P <0.01,respectively).② APACHEⅡscores,incidence of MODS and 28 d fatality rate in Xuebijing group were significantly lower than those of control group on the 7th day(P <0.01).③ Correlation analysis showed that CEC,APACHEⅡ scores,incidence of MODS and 28 d fatality rate were positively correlated with MAU (P <0.01).Conclusion Xuebijing has a protective effect on vascular endothelium in patients with CLS,and good clinical efficacy.MAU may be an early and good indicator for vascular endothelial injury and disease severity in patients with CLS.