Objective To investigate the clinical effect of prostaglandin E1combined with Xuebijing in the treatment of sepsis,as well as its effects on the levels of proinflammatory and anti-inflammatory cytokines.Meth-ods One hundred and thirty-six sepsis patients who were treated in the ICU of our hospital were selected and ran-domly divided intoⅠ group,Ⅱ group,Ⅲ group and control group,34 cases in each group.The patients in the Ⅰgroup,Ⅱ group and Ⅲ group were treated with prostaglandin E1+Xuebijing,prostaglandin E1and Xuebijing,re-spectively,and the patients in the control group received no other treatment except basic treatment.The A-PACHE score and Marshall score changes,and the changes of proinflammatory and anti-inflammatory cytokines levels of four groups were compared.The mechanical ventilation time,ICU stay,28-day mortality and incidence of adverse reactions during treatment of four groups were compared.Results The APACHE Ⅱ score and Marshall score of patients in four groups after treatment were significantly lower than those before treatment(P<0.05). The APACHE Ⅱ score and Marshall score in Ⅰ,Ⅱ and Ⅲ groups after treatment were significantly lower than those in the control group(P<0.05),and the decreasing in the Ⅰ group was more significant(P<0.05).The IL-1β,IL-6 and TNF-α levels in Ⅰ,Ⅱ and Ⅲ groups were lower than those in the control group(P <0.05). The IL-10 level in the Ⅰ and Ⅱ groups was higher than that in the control group(P <0.05).The IL-1β,IL-6 and TNF-α levels in the I group were lower than those in the Ⅱ and Ⅲ groups,while the IL-10 level was higher than Ⅱ and Ⅲ group,and the differences were statistically significant(P <0.05).The mechanical ventilation time,ICU stay and 28-day mortality in the Ⅰ,Ⅱ and Ⅲ group were significantly lower than those in the control group,and the differences were statistically significant(P <0.05).Compared with Ⅱ and Ⅲ group,the me-chanical ventilation time and ICU stay were lower in the Ⅰ group,and the differences were statistically significant (P <0.05).No serious adverse reactions occurred during the treatment in four groups.Conclusion Prostaglan-din E1combined with Xuebijing has better clinical effect in the treatment of sepsis,it can inhibit the inflammatory response in vivo,shorten the hospital stay,speed up patientsˊrecovery and reduce mortality.%目的 探讨脓毒症采用前列腺E1与血必净联合治疗的临床效果及对促炎及抗炎因子水平的影响.方法 选取136例入住我院重症监护病房(ICU)的脓毒症患者,随机分为Ⅰ、Ⅱ、Ⅲ和对照组,每组34例,Ⅰ、Ⅱ、Ⅲ组分别给予前列腺素E1+血必净、前列腺素E1、血必净治疗,对照组除基础治疗外不做任何处理.对比4组患者治疗前后急性生理和慢性健康状况评分Ⅱ(APACHE Ⅱ)和Marshall评分变化、促炎及抗炎因子水平变化.对比4组患者机械通气时间、ICU住院时间、28d病死率及治疗期间出现的不良反应情况.结果 4组患者治疗后的APACHE Ⅱ评分和Marshall评分与治疗前比较明显较低(P<0.05).Ⅰ组、Ⅱ组、Ⅲ组治疗后的A-PACHE Ⅱ评分和Marshall评分与对照组比较明显较低(P<0.05),Ⅰ组降低程度更为明显(P<0.05).与对照组比较,Ⅰ组、Ⅱ组、Ⅲ组白细胞介素(IL)-1β、IL-6、肿瘤坏死因子(TNF)-α水平明显较低(P<0.05).与对照组比较,Ⅰ组、Ⅱ组IL-10水平明显较高(P<0.05).与Ⅱ组、Ⅲ组比较,Ⅰ组IL-1β、IL-6、TNF-α水平明显较低,IL-10水平明显较高,差异有统计学意义(P<0.05).与对照组比较,Ⅰ组、Ⅱ组、Ⅲ组机械通气时间、ICU住院时间明显较少,28d病死率明显较低,差异有统计学意义(P<0.05).与Ⅱ组、Ⅲ组比较,Ⅰ组机械通气时间、ICU住院时间明显较少,差异有统计学意义(P<0.05).4组患者在治疗期间均未出现严重不良反应.结论 脓毒症采用前列腺E1与血必净联合治疗的临床效果较好,能抑制体内炎症反应,缩短住院时间,加快患者恢复,降低病死率.
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