目的 探討注射用多黏菌素E甲磺酸鈉聯(lián)合血必凈注射液治療膿毒癥的療效。方法 選取2021年3月—2023年2月在重慶大學(xué)附屬涪陵醫(yī)院ICU接受治療的104例膿毒癥患者作為研究對象。按隨機(jī)數(shù)字表法將104例患者分為對照組和治療組，各52例。對照組靜脈滴注血必凈注射液，100 mL血必凈注射液溶入100 mL 0.9%氯化鈉注射液，3次/d。治療組在對照組治療的基礎(chǔ)上靜脈注射注射用多黏菌素E甲磺酸鈉，2.5 mg/kg，分2～4次給藥，最大劑量不超過5 mg/kg。治療期間若發(fā)生腎損傷患者，劑量減少為每日所需劑量一半，注射頻率為1次/12 h。兩組均治療7～10 d。比較兩組臨床療效、病情程度、血清炎癥因子。結(jié)果 治療后，治療組總有效率達(dá)到92.31%，對照組總有效率為76.92%，治療組總有效率明顯高于對照組（P＜0.05）。治療后，兩組急性生理與慢性健康（APACHE Ⅱ）評分、序貫器官衰竭評估（SOFA）評分均顯著降低（P＜0.001）；并且治療組APACHE Ⅱ評分、SOFA評分低于對照組（P＜0.05）。治療后，兩組血清C反應(yīng)蛋白（CRP）、降鈣素原（PCT）、白細(xì)胞介素-6（IL-6）水平均顯著降低（P＜0.001）；治療組血清炎癥因子水平均低于對照組（P＜0.05）。治療期間，治療組腎損傷發(fā)生率高于對照組（P＜0.05）。結(jié)論 注射用多黏菌素E甲磺酸鈉聯(lián)合血必凈注射液治療膿毒癥能提高抗菌療效，可明顯改善病情，減輕機(jī)體炎癥反應(yīng)，但在治療期間會(huì)增加腎損傷發(fā)生風(fēng)險(xiǎn)，建議在治療過程中對患者進(jìn)行腎功能監(jiān)測。

Objective To investigate the efficacy of Colistimethate Sodium for injection combined with Xuebijing Injection in treatment of sepsis. Methods Patients (104 cases) with sepsis in ICU of Fuling Hospital Affiliated to Chongqing University from March 2021 to February 2023 were divided into control and treatment groups using the random number table method, and each group had 52 cases. Patients in the control group were iv administered with Xuebijing Injection, 100 mL added into 0.9% sodium chloride injection 100 mL, three times daily. Patients in the treatment group were iv administered with Colistimethate Sodium for injection on the basis of the control group, 2.5 mg/kg, the dosage was divided into 2 to 4 doses, with the maximum dose not exceeding 5 mg/kg, in patients with kidney injury during treatment, the dose was reduced to half of the required daily dose, and the injection frequency was once per 12 h. Patients in two groups were treated for 7 to 10 d. The clinical efficacies, state of illness, and serum inflammatory factors were compared between two groups. Results After treatment, the total effective rate of the treatment group reached 92.31%, the total effective rate of the control group was 76.92%, and the total effective rate of the treatment group was higher than that of the control group (P < 0.05). After treatment, APACHE Ⅱ score and SOFA score were significantly decreased in two groups (P < 0.05), and APACHE Ⅱ scores and SOFA scores in the treatment group were lower than those in the control group (P < 0.05). After treatment, the serum levels of CRP, PCT, and IL-6 were significantly decreased in two groups (P < 0.05), and the serum inflammatory factors levels in treatment group were lower than those in control group (P < 0.05). The incidence of kidney injury in the treatment group was higher than that in the control group (P < 0.05). Conclusion Colistimethate Sodium for injection combined with Xuebijing Injection in treatment of sepsis can improve antibacterial effect, significantly improve the condition and reduce the inflammatory response of the body, but it will increase the risk of kidney injury during treatment. It is recommended to monitor the kidney function during treatment.

R977

重慶市自然科學(xué)基金資助項(xiàng)目（cstc2021jcyj-msxmX0628）；重慶市衛(wèi)計(jì)委中醫(yī)藥科研項(xiàng)目（2023WSJK139）