2025 年第 2 期 第 20 卷

血必净联合乌司他丁治疗脓毒症的临床效果观察

Clinical effect of Xuebijing combined with ulinastatin in the treatment of sepsis

作者：杨晓婷1李丹1赵黎晓1张楠2苏海燕3王艳4徐丹丹2赵立俊2

英文作者：Yang Xiaoting1 Li Dan1 Zhao Lixiao1 Zhang Nan2 Su Haiyan3 Wang Yan4 Xu Dandan2 Zhao Lijun2

单位：1河北省张家口市第一医院呼吸科，张家口075000；2河北省衡水市第七人民医院检验科，衡水053800；3河北省衡水市第四人民医院检验科，衡水053000；4河北省衡水市第六人民医院内科，衡水053200

英文单位：1Department of Respiratory Zhangjiakou First Hospital Hebei Province Zhangjiakou 075000 China; 2Department of Laboratory Hengshui Seventh People′s Hospital Hebei Province Hengshui 053800 China; 3Department of Laboratory the No.4 People Hospital of Hengshui Hebei Province Hengshui 053000 China; 4Department of Internal Medicine the Sixth People′s Hospital of Hengshui Hebei Province Hengshui 053200 China

关键词：脓毒症；血必净；乌司他丁

英文关键词：Sepsis;Xuebijing;Ulinastatin

• 摘要：

• 目的 探讨血必净联合乌司他丁治疗脓毒症的临床效果。方法 选取2022年3月至2024年1月河北省张家口市第一医院收治的78例脓毒症患者，采用随机数字表法分为观察组和对照组，各39例。对照组在综合性治疗基础上接受注射用乌司他丁治疗；观察组在对照组基础上联合血必净注射液治疗，2组均治疗1周并随访至出院。比较2组临床疗效，中医证候量表（TCM）评分、急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分、序贯器官功能衰竭评估量表（SOFA）评分、血栓弹力图（TEG）参数、血清学相关指标及不良反应发生情况。结果 治疗后，观察组临床总有效率高于对照组［94.9%（37/39）比79.5%（31/39）］（χ2=4.129，P=0.042）。治疗后，2组TCM、APACHEⅡ、SOFA评分均低于治疗前，且观察组均低于对照组（均P<0.05）；2组TEG反应时间、凝固时间、血栓最大幅度均短于/低于治疗前，且观察组均短于/低于对照组（均P<0.05）；2组血清肌酐、胱抑素C、降钙素原、中性粒细胞明胶酶相关载脂蛋白、肾损伤分子1、微小RNA-223、微小RNA-155水平均低于治疗前，且观察组均低于对照组（均P<0.05）。治疗期间2组不良反应发生率比较差异无统计学意义（P＞0.05）。结论 血必净联合乌司他丁可改善脓毒症患者临床症状、脏器功能，降低病情严重程度，稳定TEG参数，控制机体炎症反应，缓解肾损伤，疗效显著的同时安全性良好。

• Objective To investigate the clinical effect of Xuebijing combined with ulinastatin in the treatment of sepsis. Methods Totally 78 patients with sepsis admitted to Zhangjiakou First Hospital, Hebei Province from March 2022 to January 2024 were selected. Patients were divided into observation group and control group by random number table method, with 39 cases in each group. The control group received ulinastatin for injection on the basis of comprehensive treatment. The observation group was treated with Xuebijing injection on the basis of the control group. Both groups were treated for 1 week and followed up until discharge. The clinical efficacy, traditional Chinese Medicine syndrome scale (TCM) score, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, sequential organ failure assessment (SOFA) score, thromboelastography (TEG) parameters, serological indicators and adverse reactions were compared between the two groups. Results After treatment, the total clinical effective rate of the observation group was higher than that of the control group ［94.9%(37/39) vs 79.5%(31/39)］(χ2=4.129, P=0.042). After treatment, the TCM, APACHEⅡ and SOFA scores of the two groups were lower than those before treatment, and those of the observation group were lower than those of the control group (all P<0.05). The TEG reaction time, coagulation time and maximum amplitude of thrombosis in the two groups were shorter/lower than those before treatment, and those in the observation group were shorter/lower than those in the control group (all P<0.05). The levels of serum creatinine, cystatin C, procalcitonin, neutrophil gelatinase-associated lipocalin, kidney injury molecule 1, microRNA-223 and microRNA-155 in the two groups were lower than those before treatment, and those in the observation group were lower than those in the control group (all P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups during treatment (P>0.05). Conclusion Xuebijing combined with ulinastatin can improve the clinical symptoms and organ function of patients with sepsis, reduce the severity of the disease, stabilize TEG parameters, control the inflammatory response of the body, relieve kidney injury, with significant efficacy and good safety.