【作者】 李佳寅；

【导师】 徐秋萍；

【作者基本信息】 浙江大学 ， 感染性休克， 2012， 硕士

【摘要】 目的：研究参附注射液治疗感染性休克患者的疗效。方法：将符合感染性休克入选标准的16例患者随机分配到治疗组(SF组,n=8)和对照组(non-SF组,n=8),两组同时给予6h的EGDT方案治疗,并选用合理抗生素。治疗组给予6天疗程的参附注射液治疗。对照组给予同等剂量和疗程的生理盐水。观察参附注射液治疗前、治疗后6h、12h、24h、6d的血乳酸值；分别测定参附注射液治疗前、治疗后24h,48h血中炎症介质TNFα、IL-6的浓度；用PiCCO技术分别测定参附注射液治疗前,及治疗后48h的血流动力学参数心输出量指数(CI)、外周血管阻力指数(SVRI)、血管外肺水指数(ELVWI)。观察两组的7天及28天死亡率,总住ICU天数及可能发生的药物不良反应事件。结果：(1)治疗组在治疗后12h、24h血乳酸水平显著低于对照组(2.3±0.21mmol/L vs3.21±0.40mmol/L,p=0.002;1.59±0.20mmol/L vs2.91±0.3mmol/L,p=0.001)。(2)治疗组在治疗48h后血中TNF-α及IL-6显著低于对照组(58.32±9.63pg/ml vs70.24±10.12pg/ml,p=0.239;203.91±22.46pg/ml vs245.48±24.30,p=0.168).(3)在治疗48h后CI显著高于对照组(3.9±0.94L/min/m2vs3.1±0.82L/min/m2, p=0.002),两组间SVRI及EVLWI无显著性差异(p>0.05)。(4)两组在7天及28天死亡率(两者相同),住ICU天数均无显著性差异(25%vs37.5%,p>0.05,29±13.5天vs27±14.2天,p>0.05)。(5)用药期间未发现任何药物不良反应事件。结论：参附注射液治疗能降低感染性休克患者早期的血乳酸浓度,减少炎症介质TNF-a及IL-6,增加心输出量。更多还原

【Abstract】 Objective:To evaluate the efficacy and safety of the shenfu injection (SF) in patients with septic shockMethods:16patients with septic shock received Early goal-directed resuscitation(EGDT), antibiotics and other basic treatment were randomized to2groups:SF group (n=8) received SF and non-SF group (n=8) received placebo (NS) for6days. The blood sample were drawn respectively before and6h,12h,24h,6d after drug administration for the mesurement of lactic acid and drawn before and24h,48h after drug administration for the mesurement of TNF-a, IL-6. The The values of hemodynamics including CI, SVRI, EIVWI were mesured before and48h after drag adminstration with PiCCO. The mortality rate were observed and compared at7days,28days, as the ICU stay time.Results: 1) The lactic acid in the SF group were significantly lower than in the non-SF group12h,24h after adminstration (2.3±0.21mmol/L vs3.21±0.40mmol/L,p=0.002;1.59±0.20mmol/L vs2.91±0.3mmol/L,p=0.001).2) The TNF-a, IL-6in the SF group were significantly lower than in the non-SF group48h after administration (58.32±9.63pg/ml vs70.24±10.12pg/ml, p=0.239;203.91±22.46pg/ml vs245.48±24.30, p=0.168).3) The CI in the SF group were significantly higher than in the non-SF group48h after adminstration (3.9±0.94L/min/m2vs3.1±0.82L/min/m2, p=0.002), and no statistical difference were found in SVRI and ELVWI.4) The mortality rate were37.5%and25%for non-SF and SF group,(p>0.05). And ICU stay time were29±13.5d and27±14.2d for non-SF and SF group,(p>0.05).Conclusion:In the septic shck patients, SF effectively reduced the lactic acid in the early time, had an inhibitory effect on plasma cytokines TNF-a and IL-6, and elevated the CI significantly.更多还原