目的 探討血必凈注射液聯(lián)合利奈唑胺葡萄糖注射液治療膿毒癥的臨床療效。方法 選取2021年6月—2023年6月在宜興市第六人民醫(yī)院就診的82例膿毒癥患者作為研究對象，按照計算機隨機排列法將所有患者分為對照組和治療組，各有41例。對照組靜脈滴注利奈唑胺葡萄糖注射液，600 mg/次，1次/12 h。治療組在對照組基礎(chǔ)上靜脈滴注血必凈注射液，50 mL加入100 mL的生理鹽水中，在30～40 min輸注完畢，2次/d。兩組患者連續(xù)治療10 d。觀察兩組臨床療效，并比較兩組治療后的癥狀恢復(fù)時間、病情程度、外周血管阻力指數(shù)（SVRI）、每搏指數(shù)變異度（SVV）、血管外肺水指數(shù)（ELVWI）以及CD163、高遷移率族蛋白B1（HMGB1）、中性粒細胞/淋巴細胞的比值（NLR）的變化。結(jié)果 治療后，治療組的總有效率達87.80%，對照組總有效率為68.29%，組間對比差異具有統(tǒng)計學(xué)意義（P＜0.05）。治療后，治療組患者完成復(fù)蘇時間、血壓復(fù)常時間、體溫恢復(fù)時間均比對照組短，差異有統(tǒng)計學(xué)意義（P＜0.05）。治療后，兩組的急性生理學(xué)與健康狀況評分量表（APACHE II）評分明顯低于治療前（P＜0.05），且治療組APACHE II評分較對照組更低，差異有統(tǒng)計學(xué)意義（P＜0.05）。治療后，兩組的SVRI、SVV、ELVWI低于治療前（P＜0.05）；治療后，治療組的SVRI、SVV、ELVWI低于對照組，差異有統(tǒng)計學(xué)意義（P＜0.05）。治療后，兩組的血清CD163、HMGB1水平、NLR低于治療前（P＜0.05）；治療后，治療組的血清CD163、HMGB1水平、NLR低于對照組，差異有統(tǒng)計學(xué)意義（P＜0.05）。結(jié)論 血必凈注射液聯(lián)合利奈唑胺葡萄糖注射液可提高膿毒癥的治療效果，促進患者復(fù)蘇，減輕病情嚴重程度，改善患者的心排出量，降低炎癥程度。

Objective To investigate the clinical effect of Xuebijing Injection combined with Linezolid and Glucose Injection in treatment of sepsis. Methods Patients (82 cases) with sepsis in Yixing City Sixth People’s Hospital from June 2021 to June 2023 were divided into control and treatment groups according to the computer random arrangement method, and each group had 41 cases. Patients in the control group were iv administered with Linezolid and Glucose Injection, 600 mg/time, once every 12 h. Patients in the treatment group were po administered with Xuebijing Injection on the basis of the control group, 50 mL added into normal saline 100 mL, the infusion was completed within 30 — 40 min, twice daily. Patients in two groups were treated for 10 d. After treatment, the clinical efficacies were evaluated, and the symptom recovery time, disease severity, SVRI, SVV, ELVWI, CD163, HMGB1, and NLR in two were compared. Results After treatment, the total effective rate of the treatment group was 87.80%, while that of the control group was 68.29%, and the difference was statistically significant (P < 0.05). After treatment, the recovery time, blood pressure normalization time, and temperature recovery time of the treatment group were shorter than those of the control group, and the difference was statistically significant (P < 0.05). After treatment, APACHE Ⅱ score of two groups was significantly lower than that before treatment (P < 0.05). After treatment, APACHE Ⅱ score of the treatment group was significantly lower than that of the control group, the difference was statistically significant (P < 0.05). After treatment, SVRI, SVV, and ELVWI of two groups were lower than those before treatment (P< 0.05). After treatment, SVRI, SVV, and ELVWI of the treatment group were lower than those of the control group, and the difference was statistically significant (P < 0.05). After treatment, the serum levels of CD163, HMGB1 and the NLR in two groups were lower than those before treatment (P< 0.05), and the serum levels of CD163, HMGB1 and the NLR of the treatment group were lower than those of the control group, and the difference was statistically significant (P < 0.05). Conclusion Xuebijing Injection combined with Linezolid and Glucose Injection can improve the treatment effect of sepsis, promote the recovery of patients, reduce the severity of the disease, improve the cardiac output of patients, and reduce the degree of inflammation.

R976

江蘇省衛(wèi)生健康委科研課題（Z2018011）