Objective It is to observe the effect of Xuebijing injection combined with large dose of ambroxol in the treat -ment of severe pneumonia complicated with acute respiratory distress syndrome ( ARDS) and investigate the influence on the expression of thromboxane B 2 (TXB2), endothelin -1 (ET-1) and interleukin -8 (IL-8).Methods Eighty-four pa-tients of severe pneumonia complicated with ARDS were randomly divided into observation group and control group , 42 cases in each group .All the patients were treated with anti infection , limited fluid management , glucocorticoid , nutrition support and mechanical ventilation .On this basis, the control group was given 500 mg ambroxol hydrochloride +250 mL normal saline infusion, two times per day;the observation group was treated with 50 mL Xuebijing injection +250 mL normal saline infu-sion, 2 times a day.Continuous treatment for seven days in the two groups .The acute physiology and chronic health evaluation ( APACHE II) , Murray lung injury score ( MLIS) , clinical pulmonary infection score ( CPIS) and ventilator parameters [ in-trinsic positive end expiratory pressure (PEEPi), airway resistance (R), static compliance (Cst)], the index of blood gas a-nalysis (lactic acid, oxygen pressure and oxygenation index ) and the levels of plasma TXB2, ET-1, IL-8 were observed in the both groups before treatment and on the 3rd, 5th, 7th day after treatment .Results On the 3rd, 5th, 7th day after treat-ment, the APACHE, MLIS and CPIS II score and PEEPi , R, lactic acid levels in the two groups were significantly decreased (all P<0.05), and Cst, oxygen pressure and oxygenation index were significantly increased (all P<0.05), and the im-provement of the above indexes in the observation group were obviously better than the control group ( all P<0.05);the levels of plasma TXB2, ET-1 and IL-8 were significantly increased in the both groups after treatment (all P<0.05), and to reach the peak on the 3rd day (P<0.05), the above indexes of the observation group were significantly lower than that of the control group (all P<0.05).Conclusion High dose ambroxol combined with Xuebijing injection in the treatment of severe pneumonia complicated with ARDS can effectively control the infection , improve the patient ’ s condition and respiratory func-tion, its mechanism may be related to the inhibition on plasma levels of TXB 2, ET-1 and IL-8.%目的：观察血必净注射液联合大剂量氨溴索治疗重症肺炎合并急性呼吸窘迫综合征（ARDS）的疗效及对血栓素B2（TXB2）、内皮素－1（ET－1）、白细胞介素（IL）－8表达的影响。方法将84例重症肺炎合并ARDS患者随机分为观察组42例和对照组42例。2组均给予抗感染、限制性液体管理、糖皮质激素、营养支持及机械通气治疗。在此基础上，对照组给予盐酸氨溴索500 mg＋生理盐水250 mL静滴，2次／d；观察组在对照组治疗基础上给予血必净注射液50 mL＋生理盐水250 mL静滴，2次／d。2组均连续治疗7 d。观察2组治疗前及治疗第3，5，7天的急性生理与慢性健康评分（APACHEⅡ）、Murray肺损伤评分（MLIS）、临床肺部感染评分（CPIS）、呼吸机参数[内源性呼气末正压（PEEPi）、气道阻力（R）、静态顺应性（Cst）]、血气分析指标（乳酸、氧分压、氧合指数）和血浆TXB2、ET－1、IL－8水平。结果2组治疗第3，5，7天的APACHEⅡ、MLIS及CPIS评分和PEEPi、R、乳酸水平均显著降低（P均＜0．05），而Cst、氧分压、氧合指数均显著升高（P均＜0．05），且观察组上述时间点各指标改善情况均明显优于对照组（P均＜0．05）；2组治疗后血浆TXB2、ET－1、IL－8水平均明显升高（P均＜0．05），且在第3天达到高峰（P均＜0．05），观察组上述指标水平均明显低于对照组（P均＜0．05）。结论大剂量氨溴索联合血必净注射液治疗能够有效控制重症肺炎合并ARDS患者感染状况，改善患者病情及呼吸功能，其机制可能与抑制血浆TXB2、ET－1、IL－8水平有关。
展开▼
