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目的:探讨痰热清注射液对急性肺损伤(ALI)肺功能的保护作用及对血管内皮因子的影响。方法:124例ALI患者随机分为观察组和对照组各62例,对照组采用常规急救治疗措施,包括静脉通道建立、循环支持、吸氧、抗生素应用及原发创伤处理等;观察组在对照组治疗基础上加用痰热清注射液20 mL加入5%葡萄糖注射液250 mL中静脉滴注,1次/d,疗程7 d;观察血气分析指标,全身炎性反应综合征(SIRS)及健康状况评分(APACHEⅡ评分),检测内皮素-1(ET-1),血管内皮生长因子(VEGF)及血管性假血友病因子(vWF)。结果:治疗3,7 d观察组氧分压(PO2),二氧化碳分压(PCO2)及氧合指数(PO2/FiO2)均较对照组上升更为显著(P<0.01);治疗后观察组SIRS及APACHEⅡ评分均低于对照组(P<0.05,P<0.01);治疗3,7 d观察组ET-1,VEGF,vWF水平均低于同期对照组(P<0.01);观察组发生机械通气例数及肺感染例数少于对照组(P<0.05)。结论:痰热清能降低血清ET-1,VEGF,vWF水平,减轻了血管内皮的损伤,减轻了肺水肿,保护了肺功能。
Objective: To investigate the protective effect of Tanreqing Injection on pulmonary function of acute lung injury (ALI) and its effect on vascular endothelial factor. Methods: One hundred and twenty-four patients with ALI were randomly divided into two groups: observation group (62 cases) and control group (62 cases). The control group received routine emergency treatment including venous channel establishment, circulation support, oxygen inhalation, antibiotic application and primary trauma. On the basis of the treatment, 20 mL of Tanreqing injection plus 250 mL of 5% dextrose injection was injected intravenously once a day for 7 days. Blood gas analysis indexes, systemic inflammatory response syndrome (SIRS) and The health status score (APACHEⅡscore) was used to detect ET-1, VEGF and vWF. Results: The oxygen partial pressure (PO2), the partial pressure of carbon dioxide (PCO2) and the oxygenation index (PO2 / FiO2) in the observation group on the 3rd and 7th day after treatment were all significantly higher than those in the control group (P <0.01) (P <0.05, P <0.01). The levels of ET-1, VEGF and vWF in the observation group on the 3rd and 7th day after treatment were all lower than those in the control group (P <0.01), and the mechanical ventilation The number of cases and the number of lung infections were less than those in the control group (P <0.05). Conclusion: Tanreqing can reduce serum ET-1, VEGF, vWF levels, reduce vascular endothelial damage, reduce pulmonary edema, protect the lung function.