参麦注射液使用剂量与呼吸机相关性肺炎患者免疫功能及治疗效果的相关性研究

Correlation Between the Dose of Shenmai Injection and the Immune Function and Therapeutic Effect of Ventilator Associated Pneumonia

关键词:  参麦注射液  呼吸机相关性肺炎  免疫  感染

Key words:  Shenmai injection  ventilator associated pneumonia  immune  infection

摘要:

目的 探讨不同剂量参麦注射液对呼吸机相关性肺炎（ventilatorassociated pneumonia，VAP）患者免疫功能及治疗效果的影响。方法 将93例呼吸机相关性肺炎患者随机分为对照组（32例，常规治疗）、低剂量干预组（28例，在常规治疗基础上加用参麦注射液50 mL qd）、高剂量干预组（33例，在常规治疗基础上加用参麦注射液100 mL qd），治疗疗程14 d。比较3组患者的感染指标[外周血白细胞（WBC）、C反应蛋白（CRP）和降钙素原（PCT）]、免疫指标（CD4⁺、CD8⁺、CD4⁺/CD8⁺）、医疗指标（机械通气时间、入住ICU时间、28 d及60 d生存率）和安全性。结果 高剂量干预组治疗后CRP、PCT、CD4⁺、CD8⁺较对照组改善明显，高、低剂量干预组机械通气时间、入住ICU时间较对照组明显下降，28 d及60 d生存率较对照组明显提高，差异有统计学意义（P<0.05）。结论 参麦注射液能改善呼吸相关性肺炎患者的感染指标，有明显的免疫促进作用，能提高VAP患者的治疗疗效，且100 mL参麦注射液临床效果更加显著。

Abstract:

OBJECTIVE To investigate the effects of different doses of Shenmai injection on immune function and therapeutic effect in patients with ventilator-associated pneumonia. METHODS Ninety-three patients with ventilator- associated pneumonia were randomly divided into three groups:control group(32 cases) was given conventional treatment, low-dose intervention group(28 cases) was added with "Shenmai injection 50 mL qd" on the basis of conventional treatment, and high-dose intervention group(33 cases) was added with "Shenmai injection 100 mL qd" on the basis of conventional treatment for 14 d. The indicators included infection index(WBC, CRP, PCT), immune index(CD4⁺, CD8⁺ and CD4⁺/CD8⁺) and medical index(duration of mechanical ventilation, length of stay in the ICU, survival at 28 and 60 d) of 3 groups were compared. RESULTS After treatment, CRP, PCT, CD4⁺ and CD8⁺ in the high-dose intervention group were significantly improved compared with those in the control group; mechanical ventilation time in the low-dose intervention group and the high-dose intervention group was significantly reduced compared with that in the control group; survival rate at 28 d and 60 d was significantly improved compared with that in the control group, and the difference was statistically significant(P<0.05). CONCLUSION Shenmai injection can improve the infection index of patients with respiratory related pneumonia, has an obvious immune promoting effect, and can improve the therapeutic effect of VAP patients. And the clinical effect of 100 mL Shenmai injection is more significant.