血必净注射液对脓毒症患者MYO、Cys C及KIM-1的影响

摘要

目的 观察血必净注射液对脓毒症患者肌红蛋白(MYO)、胱抑素C(Cys C)及尿肾损伤分子1(KIM-1)的影响.方法 选取2015年1月至2016年7月收住重症医学科脓毒症患者为研究对象,按简单随机法将患者分为对照组和血必净组各45例.对照组给予脓毒症基础治疗;治疗组同时予血必净注射液治疗(血必净注射液100 mL静脉滴注,每日1次),疗程为7d.观察两组患者治疗前和治疗后1、3、7d急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分;检测两组治疗前及治疗3d和7d血中肌酐(SCr)、MYO、Cys C、KIM-1等.结果 两组各45例患者中,48 h内每组死亡2例,均予以剔除,最终纳入资料完整且符合观察要求的患者各43例.两组治疗前APACHEⅡ评分比较差异均无统计学意义(P＞0.05);治疗3d、7d均较治疗前明显降低,且治疗7d时血必净组较对照组下降更为显著(P＜0.05).两组治疗前SCr、MYO、Cys C、KIM-1水平比较差异均无统计学意义(P＞0.05);血必净组治疗后上述指标的改善程度均明显优于对照组,以治疗3d时改善更为显著(P＜0.05).结论 血必净注射液减少脓毒症患者MYO及Cys-C分泌,下调KIM-1表达以保护肾功能.%Objective:To observe the effect of Xuebijing Injection on the expression of MYO,Cys C and KIM-1 in patients with sepsis.Methods:The patients with sepsis were randomly divided into the control group and Xuebijing group,with 45 cases in each.The patients in both groups received basic treatment for sepsis,and the patients in Xuebijing group were additionally given intravenous injection of Xuebijing 100 mL once a day for 7 days.In both groups,the changes in acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score were observed before treatment and 1,3,7 days after treatment,and the changes in the levels of SCr,MYO,Cys C and KIM-1 were determined before treatment and 1 day and 7 days after treatment.Results:Between the two groups,there were 2 cases of death within 48 hours in each group,and a total of 43 patients with complete data were enrolled in each group.There was no statistically significant difference in APACHE Ⅱ score before treatment between two groups (P＞ 0.05).However,APACHE Ⅱ scores were significantly decreased in both groups 3 days and 7 days after treatment compared with those before treatment,and the degree of decrease in Xuebijing group was more obvious 7 days after treatment (P ＜ 0.05).Serum concentrations of SCr,MYO,Cys C and KIM-1 showed no difference between two groups before treatment (all P＞ 0.05),while after treatment,the degrees of improvement of above indexes in Xuebijing group were obviously superior to those in the control group,especially 3 days after treatment(P＜ 0.05).Conclusion:Xuebijing Injection can inhibit MYO and Cys C secretion in patients with sepsis,and down-regulate the expressions of KIM-1 to protect the renal tubule function.