杨兴才; 楼丹飞; 韦红; 郑天虹; 卜建宏; 闫国良; 李越华

doi:10.3760/cma.j.issn.1673-4246.2018.07.003

点赞 0
分享 0
收藏 0
纠错

• 论著 •

抗炎合剂对脓毒症患者血管内皮细胞功能的影响

国际中医中药杂志, 2018,40(7) : 587-591. DOI: 10.3760/cma.j.issn.1673-4246.2018.07.003

摘要

目的

观察抗炎合剂对脓毒症血管内皮细胞(vascular endothelial cell, VEC)损伤-微循环障碍-脏器功能障碍的临床疗效。

方法

共纳入73例患者，采用随机数字表法将研究对象分为治疗组40例，对照组33例。对照组给予常规西医综合治疗，治疗组在对照组基础上加用抗炎合剂，2组均连续治疗7 d。观察治疗前后2组患者的血管内皮损伤指标可溶性血栓调节素(soluble thrombomodulin, sTM)、VEGF-2、内皮特异性分子-1(endothelial specific molecule-1, ESM-1)，微循环障碍指标动脉血乳酸(lactate, Lac)、中心静脉血氧饱和度(central venous blood oxygen saturation, ScvO₂)、舌下微血管的总血管密度(total vessel density, TVD)、灌注血管密度(perfused vessel density, PVD)、灌注血管比例(proportion of perfused vessels, PPV)、微血管流动指数(microcirculatory flow index, MFI)。记录治疗前后序贯器官衰竭评分(Sequential Organ Failure Assessment, SOFA)。

结果

治疗7 d后中药抗炎合剂治疗组sTM[(12.37±5.08)μg/L比(18.77±6.88)μg/L，t＝3.448]、VEGF-2[45.6 ng/L(14.3，112.5)比52.4 ng/L(17.2，123.6)，Z＝4.009]、ESM-1[(15.54±4.09)ng/ml比(17.64±6.79)ng/ml，t＝-1.551]，Lac [(2.6±1.2)mmol/L比(3.7±1.8)mmol/L，t＝2.366]和SOFA[(4.1±1.7)比(6.1±3.2)，t＝-2.118]低于对照组(P<0.05)；ScvO₂[(0.719±0.243)比(0.603±0.201)，t＝-2.773]，PVD[(14.8±5.8)mm/mm²比(13.1±5.1)mm/mm²，t＝-5.114]，PPV[(59.1%±22.5%)比(53.9%±20.6%)，t＝1.779]，MFI[(9.4±4.6)比(7.2±2.2)，t＝4.339]高于对照组(P<0.05)。相关性分析显示，sTM与PPV为负相关(r＝-0.755，P<0.01)，ESM-1与PVD、PPV、MFI为负相关(r＝-0.877，P<0.01；r＝-0.799，P<0.01；r＝-0.821，P<0.01)；ESM-1与SOFA呈正相关(r＝0.840，P<0.01)。

结论

中药抗炎合剂可改善脓毒症患者VEC功能。

引用本文: 杨兴才, 楼丹飞, 韦红, 等. 抗炎合剂对脓毒症患者血管内皮细胞功能的影响 [J] . 国际中医中药杂志, 2018, 40(7) : 587-591. DOI: 10.3760/cma.j.issn.1673-4246.2018.07.003.

参考文献导出: Endnote NoteExpress RefWorks NoteFirst 医学文献王

扫描看全文

正文

作者信息

基金 0 关键词 0

English Abstract

阅读 0 评论 0

相关资源

引用 | 论文 | 视频

版权归中华医学会所有。

未经授权，不得转载、摘编本刊文章，不得使用本刊的版式设计。

除非特别声明，本刊刊出的所有文章不代表中华医学会和本刊编委会的观点。

脓毒症是机体对感染的反应失调而导致危及生命的器官功能障碍，在脓毒症疾病发展过程中，内皮细胞损伤及微循环功能障碍占有重要地位^[1]。研究认为，血管内皮细胞(vascular endothelial cell, VEC)不仅是炎症反应中被动的靶细胞，也是一种效应细胞，在微循环障碍、脓毒性休克及多器官功能损伤中起着重要作用^[2]。既往研究显示，中药清热解毒、活血通腑治疗对脓毒症炎症、免疫、凝血等具干预作用。本研究进一步从内皮细胞损害-微循环障碍-器官功能障碍方面观察清热通腑、活血解毒的中药抗炎合剂对脓毒症患者的治疗作用。

贡献者信息

杨兴才

200071　上海中医药大学附属市中医医院重症医学科

楼丹飞

200071　上海中医药大学附属市中医医院重症医学科

韦红

200071　上海中医药大学附属市中医医院重症医学科

郑天虹

200071　上海中医药大学附属市中医医院重症医学科

卜建宏

200071　上海中医药大学附属市中医医院重症医学科

闫国良

200071　上海中医药大学附属市中医医院重症医学科

李越华

200071　上海中医药大学附属市中医医院重症医学科

通信作者

杨兴才

200071　上海中医药大学附属市中医医院重症医学科

Email：yxc1966@126.com

关键词

脓毒症; 抗炎合剂; 复方(中药); 血管内皮细胞; 微循环障碍; 临床研究;

作者声明

作者贡献声明　杨兴才：酝酿和设计试验、实施研究、采集数据、分析/解释数据、起草文章、对文章的知识性内容作批评性审阅、统计分析、获取研究经费、行政和技术或材料支持、指导、支持性贡献；楼丹飞：起草文章、对文章的知识性内容作批评性审阅、统计分析；韦红、郑天虹、卜建宏、闫国良、李越华：实施研究、采集数据、分析/解释数据、对文章的知识性内容作批评性审阅、指导、支持性贡献

利益冲突

利益冲突申明　本文全体作者未接受过第三方的资助或服务，对文中所描述的药物、材料或器械均无个人或企业的经济利益

历史

出版日期：2018-07-30

收稿日期：2017-06-18

本文编辑

常久

Original Article

Clinical study of traditional Chinese medicine anti-inflammatory mixture for the microcirculation disturbance in patients with sepsis targetting at vascular endothelium

Xingcai Yang, Danfei Lou, Hong Wei, Tianhong Zheng, Jianhong Bo, Guoliang Yan, Yuehua Li

Published 2018-07-30

Cite as Int J Trad Chin Med, 2018, 40(7): 587-591. DOI: 10.3760/cma.j.issn.1673-4246.2018.07.003

Abstract

Objective

To observe the clinical effect of traditional Chinese medicine inflammatory mixture on vascular endothelial cell injury, mcrocirculation disorder and organ dysfunction in sepsis.

Methods

73 patients with sepsis were randomly divided into two groups: Anti-inflammatory mixture-treated group (40 cases) and control group (33 cases). Routine medicine therapy was given in both groups. Additionally, in the Anti-inflammatory mixture-treated group, 100 ml Anti-inflammatory mixture was given By oral or nasal feeding, every 12 hours for consecutive 7 days. Vascular endothelial injury index (Soluble thrombomodulin,Vascular endothelial growth factor-2, endothelial specific molecule-1), mcrocirculation disorder index (arterial blood lactate, central venous oxygen saturation, total vessel density, perfused vessel density, proportion of perfused vessels, microcirculatory flow index) of two group patients before and after therapy were observed and the sequential organ failure score (SOFA) was recorded before and after treatment.

Results

After treatment, the indexes of vascular endothelial injury sTM (12.37 ± 5.08 μg/L vs. 18.77 ± 6.88 μg/L, t=3.448), VEGF-2 [45.6 ng/L (14.3, 112.5) vs. 52.4 ng/L (17.2, 123.6), Z=4.009], ESM-1 (15.54 ± 4.09 ng/ml vs. 17.64 ± 6.79 ng/ml, t=-1.551), Lac (2.6 ± 1.2 mmol/L vs. 3.7 ± 1.8 mmol/L, t=4.115) and SOFA (4.1 ± 1.7 vs. 6.1 ± 3.2, t=-2.118) in anti-inflammatory mixture group decreased significantly than those in the control group. but the ScvO₂ (0.719 ± 0.243 vs. 0.603 ± 0.201, t=-2.773), PVD (14.8 ± 5.8 mm/mm²vs. 13.1±5.1 mm/mm², t=-5.114), PPV (59.1% ± 22.5% vs. 53.9% ± 20.6%, t=1.779), MFI (9.4 ± 4.6 vs. 7.2 ± 2.2, t=4.339) in the anti-inflammatory mixture group were significantly higher than those in the control group. Correlation analysis showed that the sTM and PPV were significantly negatively correlated (r=-0.875, P<0.01), ESM-1 was significantly negatively correlated with PVD, PPV and MFI (r=-0.877, P<0.01; r=-0.799, P<0.01; r=-0.821, P<0.01) and ESM-1 and SOFA were significantly positively correlated (r=0.840, P<0.01).

Conclusions

Anti-inflammatory mixture of Chinese medicine has a certain therapeutic effect on sepsis by protecting vascular endothelial cell function.

Key words:

Sepsis; Anti-inflammatory mixture; Compounds (TCD); Vascular endothelial cell; Microcirculatory disturbance; Clinical study

Contributor Information

Xingcai Yang

Department of Critical Care Medicine, Shanghai Municipal Hospital of Traditional Chinese Medicine, Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China

Danfei Lou

Hong Wei

Tianhong Zheng

Jianhong Bo

Guoliang Yan

Yuehua Li

共有条评论

验证码

本文被引情况 CSCD: 0次万方数据： 0次 Scopus: 0次

施引文献(最多仅列5条文献，进入CSCD官网发现更多)

未获取施引文献信息...

暂无相关资源