心脉隆注射液对脓毒症休克患者微循环的影响

doi:10.3969/j.issn.1006-5725.2024.05.007

Abstract

Abstract:

Objective To observe the effect of Xinmailong injection on microcirculation in patients with septic shock， so as to understand the application effect and value of Xinmailong injection in patients with septic shock. Methods A total of 82 patients with septic shock treated in the intensive care unit of our hospital were selected as the research objects and randomly divided into two groups. 41 patients in the control group were treated with conventional septic shock cluster therapy， and 41 patients in the treatment group were treated with Xinmailong injection on the basis of cluster therapy in the control group. Then hemodynamic parameters （HR， CVP， CO， MAP， SVR）， hemorheology （whole blood reducing viscosity， hematocrit， fibrinogen， platelet aggregation rate）， microcirculation perfusion indexes （oxygenation index， blood lactate level， SCVO₂， Pcv-aCO₂） and 28-day survival rate were detected and compared between the two groups before and after treatment. Results Before treatment， there were no significant differences in hemodynamic parameters， blood rheology and microcirculation perfusion indexes between the two groups （P > 0.05）. After treatment， the above test results of the two groups were significantly improved， and the test results of the treatment group were significantly better than those of the control group， and the 28-day survival rate was also better than that of the control group. The differences were statistically significant （P < 0.05）. Conclusion Xinmailong injection can significantly improve the hemodynamic parameters， blood rheology and microcirculation perfusion indexes， and improve the 28-day survival rate of patients with sepsis. It has a positive clinical effect in the treatment of septic shock patients.

Key words: sepsis, Xinmailong injection, microcirculation, survival rates

CLC Number:

R631⁺.4

Guangping WU,Xin YIN,Jianzhuo HE,Liheng. GUO. The effect of Xinmailong injection on microcirculation in patients with septic shock[J]. The Journal of Practical Medicine, 2024, 40(5): 627-631.

Figures/Tables 7

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References 26

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组别	例数	年龄（x ± s，岁）	性别（例）		合并症（例）
组别	例数	年龄（x ± s，岁）	男	女	糖尿病	CKD	高血压	COPD	冠心病	支气管扩张
治疗组	41	64.1 ± 15.8	26	15	6	8	10	8	11	2
对照组	41	62.4 ± 19.8	27	14	7	8	18	10	11	3

组别	例数	感染类型
组别	例数	肺部	腹腔	血源性	皮肤软组织	尿路
治疗组	41	30	10	2	2	4
对照组	41	26	16	3	2	3

组别	时间	危重评分
组别	时间	APACHE Ⅱ	SOFA	SPAS Ⅱ	MODS
治疗组	治疗前	15.9 ± 5.5	6.5 ± 4.1	40.4 ± 11.5	5.0 ± 2.9
治疗组	治疗72 h后	14.2 ± 6.0	4.7 ± 4.2	36.0 ± 12.8	3.7 ± 3.8
对照组	治疗前	18.7 ± 7.1	7.4 ± 4.2	41.1 ± 14.1	6.2 ± 3.3
对照组	治疗72 h后	16.6 ± 7.1	7.1 ± 5.1	38.9 ± 17.2	5.5 ± 4.6

组别	时间	HR（次/min）	CVP（cmH₂O）	CO（L/min）	MAP（mmHg）	SVR（Kpa·s/L）
治疗组（n = 41）	治疗前	114.3 ± 11.7	4.2 ± 3.2	3.4 ± 1.0	57.9 ± 4.9	60.32 ± 2.31
	治疗后24 h	94.1 ± 17.9^?△	6.3 ± 1.2^?△	5.0 ± 1.6^?△	75.3 ± 5.8^?△	78.14 ± 3.26^?△
	治疗后72 h	90.9 ± 14.6^?△△	7.2 ± 3.3^?△	5.0 ± 1.6^?△	80.5 ± 8.8^?△	110.54 ± 1.65^?△△
对照组（n = 41）	治疗前	113.1 ± 16.2	3.9 ± 2.8	3.4 ± 0.3	57.6 ± 7.6	59.36 ± 3.03
	治疗后24 h	97.2 ± 19.0^?	4.7 ± 2.1^?	4.1 ± 1.0^*	66.9 ± 4.3^?	71.51 ± 3.64^?
	治疗后72 h	95.1 ± 14.8^?	5.9 ± 2.0^?	4.1 ± 1.0^*	71.3 ± 10.1^?	90.76 ± 2.58^?

组别	时间	血小板聚集率（%）	纤维蛋白原（g/L）	血细胞比容（%）	全血高切黏度（mPa·s）	全血中切黏度（mPa·s）	全血低切黏度（mPa·s）	血浆比黏度（mPa·s）
治疗组（n = 41）	治疗前	65.92 ± 7.14	5.40 ± 0.71	53.87 ± 6.90	8.20 ± 1.97	5.43 ± 1.51	14.63 ± 1.23	2.16 ± 0.22
治疗组（n = 41）	治疗72 h后	51.83 ± 5.37^?△	3.58 ± 0.47^?△	44.60 ± 5.13^?△	5.84 ± 1.15^?△	3.99 ± 0.24^?△	10.42 ± 1.16^?△	1.53 ± 0.96^?△
对照组（n = 41）	治疗前	67.15 ± 5.66	5.41 ± 0.64	53.75 ± 7.27	8.28 ± 1.79	5.27 ± 1.16	14.53 ± 0.79	2.07 ± 0.25
对照组（n = 41）	治疗72 h后	63.95 ± 8.26^?	4.92 ± 0.52^?	49.43 ± 6.78^?	7.33 ± 1.26^?	4.35 ± 0.38^?	12.42 ± 1.09^?	1.94 ± 0.11^?

The effect of Xinmailong injection on microcirculation in patients with septic shock

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组别	时间	PaO₂/FiO₂（mmHg）	LAC（mmol/L）	SCVO₂（%）	Pcv-aCO₂（mmHg）
治疗组（n = 41）	治疗前	133.3 ± 16.6	5.5 ± 1.0	67.8 ± 10.2	7.4 ± 4.3
	治疗后24 h	161.0 ± 12.3^?	3.9 ± 0.7^?△△	77.9 ± 9.8^?△	3.9 ± 2.7^?△
	治疗后72 h	295.1 ± 20.9^?△	1.2 ± 1.1^?△△	88.5 ± 9.2^?△	2.7 ± 2.3^?△△
对照组（n = 41）	治疗前	138.1 ± 10.3	5.4 ± 0.9	68.1 ± 9.0	7.8 ± 5.9
	治疗后24 h	151.4 ± 12.8	3.9 ± 0.7^?	70.5 ± 7.5	5.2 ± 3.8^?
	治疗后72 h	202.8 ± 59.0^?	1.5 ± 1.3^?	75.1 ± 9.6	4.5 ± 5.2^?

组别	例数	住ICU时间（d）	28 d生存例数	28 d生存率（%）
治疗组	41	17.71 ± 6.33	28	68.3^△
对照组	41	15.74 ± 5.82	24	58.5

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