目的 觀察并探討血必凈注射液聯(lián)合烏司他丁對(duì)重癥膿毒癥患者血清因子、T細(xì)胞亞群及D-二聚體的影響。方法 入選2014年1月—2016年3月收治的150例膿毒癥患者為研究對(duì)象，隨機(jī)分為研究組和對(duì)照組各75例，對(duì)照組在抗感染、抗凝、氧療等綜合治療基礎(chǔ)上使用烏司他丁注射液，研究組在對(duì)照組基礎(chǔ)上聯(lián)合靜滴血必凈注射液，7 d為1療程，記錄并比較兩組治療前與治療7 d后血清因子、T細(xì)胞亞群及D-二聚體水平變化與多器官功能障礙綜合征（MODS）發(fā)生率及7 d病死率。結(jié)果 研究組治療7 d后腫瘤壞死因子-α（TNF-α）、白介素-6（IL-6）、C反應(yīng)蛋白（CRP）、降鈣素原（PCT）水平均顯著低于對(duì)照組（P<0.05）。研究組治療后CD³⁺、CD⁴⁺、CD⁴⁺/CD⁸⁺均顯著高于對(duì)照組（P<0.05）。研究組治療后D-dimer、APACHEⅡ評(píng)分均顯著低于對(duì)照組水平（P<0.05）；研究組7 d內(nèi)MODS發(fā)生率（13.3% vs 20.0%）與病死率（10.7% vs 13.3%）低于對(duì)照組，但差異均無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論 烏司他丁治療重癥膿毒癥基礎(chǔ)上聯(lián)合使用血必凈注射液能進(jìn)一步抑制炎癥反應(yīng)，調(diào)節(jié)細(xì)胞免疫功能，減輕高凝狀態(tài)。

Objective To observe the influences of Xuebijing injection combined with UTI on variations of serum factor, T cell subsets and D-dimer for severe sepsis patients. Methods 150 severe sepsis patients from January 2014 to March 2016 were selected and randomly divided into study group and control group, each with 75 cases, based on conventional therapy control group added with UTI injection for 7d,observation group jointly added with Xuebijing injection, variations of inflammatory factor, T cell subsets and D - dimer levels before and 7d after treatment were noted,and MODS incidence and 7 d mortality ratio of the two groups were compared. Results The study group after treatment with TNF-α, IL-6, CRP, PCT were significantly lower than the control group (P<0.05). CD³⁺, CD⁴⁺, CD⁴⁺/CD⁸⁺ of study group after treatment were significantly higher than the control group (P<0.05). D-dimer and APACHEⅡ score of study group after treatment were significantly lower than the control group (P<0.05). MODS incidence rate (13.3% vs.20.0%) and mortality ratio (10.7% vs.13.3%) of study group within 7d were both lower than the control group, but the difference were not significant. Conclusion Based on UTI treatment for severe sepsis, Xuebijing injection added can further suppress inflammatory response, regulate cell immune function, alleviate the hypercoagulable state.

秦皇島市科技支撐計(jì)劃項(xiàng)目（201401A197）