实用医学杂志 ›› 2022, Vol. 38 ›› Issue (14): 1814-1818.doi: 10.3969/j.issn.1006⁃5725.2022.14.019

• 药物与临床 • 上一篇    下一篇

血必净注射液联合低分子肝素对老年急性呼吸窘迫综合征正五聚蛋白3、乙酰肝素酶水平的影响

梁文美 付豹 赵晓宇 苏德 代大华 宫敏敏 傅小云   

  1. 遵义医科大学附属医院重症医学科(贵州遵义563000)

  • 出版日期:2022-07-25 发布日期:2022-07-25
  • 通讯作者: 傅小云 E⁃mail:fxycloudy@126.com
  • 基金资助:
    贵州省科技计划项目(编号:黔科合支撑[2021]一般 083)


Effects of Xuebijing Injection combined with low molecular weight heparin on PTX3 and HPSE levels in elderly patients with acute respiratory distress syndrome

LIANG Wenmei,FU Bao,ZHAO Xiaoyu,SU De,DAI Dahua,GONG Minmin,FU Xiaoyun.    

  1. Department of Critical Medicine,the Affiliated Hospital,Zunyi MedicalUniversity,Zunyi 563000,China
  • Online:2022-07-25 Published:2022-07-25
  • Contact: FU Xiaoyun E⁃mail:fxycloudy@126.com

摘要:

目的 分析血必净注射液联合低分子肝素对老年急性呼吸窘迫综合征(acute respiratorydistress syndrome,ARDS)患者正五聚蛋白 3(pentraxin 3,PTX3)、乙酰肝素酶(heparanase,HPSE)水平的影响。方法 收集 2019 年 1 月至 2021 年 12 月在我院治疗的 100 例老年 ARDS 患者进行前瞻性研究,随机将患者分为对照组 50 例,研究组患者 50 例,对照组采用低分子肝素治疗,研究组采用低分子肝素、血必净注射液治疗,检测两组血气指标、凝血指标、炎症因子、PTX3、HPSE、临床指标水平,对比两组临床疗效。结果 与治疗前相比,治疗后动脉血氧分压(arterial partial pressure of oxygen,PaO2)、二氧化碳分压(partial pressure of carbon dioxide,PCO2)、氧合指数(PaO2/FiO2)、纤维蛋白原(fibrinogen,FBI)、血小板计数(platelet count,PLT)表达升高,凝血酶原时间(Prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、肿瘤坏死因子⁃α(tumor necrosis factor⁃α,TNF⁃α)、白细胞介素⁃6(interleukin⁃6,IL⁃6)、白细胞介素⁃10(interleukin ⁃10,IL⁃10)、PTX3、HPSE 表达水平降低,且研究组变化幅度较大(P < 0.05)。研究组患者 APACHEⅡ评分、机械通气时间、ICU 住院时间低于对照组,治疗有效率高于对照组(P < 0.05)。结论 血必净注射液、低分子肝素联合治疗可降低老年 ARDS 患者 PTX3、HPSE,改善患者凝血功能,治疗效果较好。

关键词: 血必净注射液, 低分子肝素, 急性呼吸窘迫综合征, 正五聚蛋白3, 乙酰肝素酶

Abstract:

Objective To analyze the effects of Xuebijing injection combined with low molecular weight heparin on PTX3 and HPSE levels in elderly ARDS patients. Methods A total of 100 elderly patients with ARDS hospitalized in our hospital from January 2019 to December 2021 were engaged in the prospective study. They were randomly divided into control group(n = 50)and research group(n = 50);the former group treated with low mo⁃lecular weight heparin and the latter with Xuebijing Injection combined with low molecular weight heparin. The two groups were compared in terms of blood gas indexes,coagulation indexes,inflammatory factors,PTX3,HPSE,clinical indexes,and the clinical efficacy. Results Compared with pre ⁃ treatment,the levels of PaO2,PCO2,PaO2/FiO2,FBI,and PLT expression were increased,and the levels of PT,APTT,TNF⁃α,IL⁃6,IL⁃10,PTX3, and HPSE expression were decreased in both groups,but the changes in the levels of all the indexes in the study
group were statistically significant as compared with those in the control group(P < 0.05). Besides,the APACHE Ⅱ score was significantly lower,the mechanical ventilation time and ICU hospitalization time were both significantly shorter,and the treatment was significantly more efficient,compared with the control group(P < 0.05). Conclusion Xuebijing injection combined with low molecular weight heparin has a good therapeutic effect for elderly ARDS patients,for it can reduce PTX3 and HPSE and improve their coagulation function.

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