首都医科大学学报 ›› 2012, Vol. 33 ›› Issue (3): 297-300.doi: 10.3969/j.issn.1006-7795.2012.03.003

• 中西医结合临床与基础 • 上一篇    下一篇

参麦注射液及乌司他丁对重症脓毒症患者微循环的影响

赵梦雅, 李昂, 张淑文, 段美丽   

  1. 首都医科大学附属北京友谊医院重症医学科,北京 100050
  • 收稿日期:2012-02-20 修回日期:1900-01-01 出版日期:2012-06-21 发布日期:2012-06-21
  • 通讯作者: 段美丽

Effects of Shen-Mai injection and ulinastatin injection on microcirculation in patients with severe sepsis

ZHAO Meng-ya, LI Ang, ZHANG Shu-wen, DUAN Mei-li   

  1. Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
  • Received:2012-02-20 Revised:1900-01-01 Online:2012-06-21 Published:2012-06-21

摘要: 目的 应用旁流暗视野仪观察中药参麦注射液及西药乌司他丁对重症脓毒症患者微循环的影响。方法 采用数字表法将符合入选标准的重症脓毒症患者45例随机分为常规治疗组、参麦注射液组和乌司他丁组,每组15例。遵照SSC2008指南,在常规治疗的基础上,分别加用参麦注射液和乌司他丁治疗,应用旁流暗视野技术,观察患者治疗前后舌下微循环的变化,观察指标包括:总血管密度(total vessel density,TVD)、灌注血管密度(perfused vessel density,PVD)、灌注血管比例(proportion of perfused vessels,PPV)、微血管流动指数(microvascular flow index,MFI)。记录入组72 h的APACHE Ⅱ评分,以及患者住ICU天数及28天病死率。结果 参麦注射液组患者舌下微循环在给药6 h后出现明显变化,PPV明显增加(P<0.05)。乌司他丁组患者在给药12 h后出现明显变化,PPV明显增加(P<0.05)。参麦注射液及乌司他丁均对患者预后有一定改善作用。结论 参麦注射液及乌司他丁均可改善重症脓毒症患者早期舌下微循环;监测舌下微循环变化可作为评估患者预后的重要参考指标。

关键词: 重症脓毒症, 舌下微循环, 参麦注射液, 乌司他丁

Abstract: Objective To observe the effect of Shen-Mai injection and ulinastatin injection (UTI) on microcirculation in patients with severe sepsis.Methods Using random number table, 30 patients with severe sepsis were divided into Shen-Mai injection group and UTI group, 15 cases in each group. Following SSC2008 guide, on the basis of conventional therapy, Shen-mai injection and UTI treatment were applied to observe the changes of sublingual microcirculation in patients before and after treatment by the sidestream-dark-field technique: total vascular density (TVD), perfusion vascular density (PVD), proportion of perfused vessels (PPV), microvascular flow index (MFI) were measured, and the APACHEⅡ score was recorded 72 h after entering into the group and the number of days in ICU and 28 day mortality were compared.Results 1. The sublingual microcirculation in patients of Shen-Mai injection group had significant changes after 6h, PPV increased significantly (P<0.05). 2. The sublingual microcirculation in patients of UTI group had significant changes after 6h, PPV increased significantly (P<0.05). 3. Shen-Mai injection and UTI have a certain improvement of the prognosis of patients. Conclusion Both Shen-Mai injection and UTI could improve the sublingual microcirculation in patients with early severe sepsis; monitoring sublingual microcirculation can be used as an important index for assessing the prognosis of patients.

Key words: severe sepsis, sublingual microcirculation, Shen-Mai, ulinastatin

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