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目的观察芪参活血颗粒治疗小儿肺炎合并脓毒症临床效果。方法将肺炎合并脓毒症患儿120例随机分为观察组与对照组各60例。2组患儿均按照2012年国际严重脓毒症及脓毒症性休克诊疗指南给予规范处理,观察组在此基础上给予加用芪参活血颗粒,对照组给予等剂量温水。入院24h、第7天采用流式细胞仪检测外周血CD+4CD+25调节性T淋巴细胞(Treg细胞)比例,免疫化学发光法检测血清降钙素原(PCT)水平变化。采用雅培全自动生化分析仪检测脏器功能指标:天冬氨酸氨基转移酶(AST)、肌酐(Scr)、肌酸激酶同工酶(CK-MB)、血小板计数(PLT)、钠尿肽(BNP)水平变化。结果 2组治疗后血清PCT水平及Treg细胞比例均明显低于治疗前,且观察组低于对照组;治疗后观察组血AST、Scr、CK-MB、BNP水平明显低于对照组,PLT水平明显高于对照组,差异均有统计学意义(P<0.05)。结论芪参活血颗粒可降低肺炎合并脓毒症患儿血清降钙素原水平,降低外周血CD+4CD+25调节性T淋巴细胞比例,对脏器功能起到保护作用。
Objective To observe the clinical effect of Qishen Huoxue Granule in treating children pneumonia complicated with sepsis. Methods 120 cases of children with pneumonia and sepsis were randomly divided into observation group and control group of 60 cases. The two groups of children were treated according to the guideline of international severe sepsis and septic shock in 2012. The observation group was treated with Qishen Huoxue granule on the basis of the above, while the control group was given the same dose of warm water. On the 7th day after admission, the proportion of CD + 4CD + 25 Treg cells in peripheral blood was detected by flow cytometry and the level of procalcitonin (PCT) was detected by immunochemiluminescence. Abbott automatic biochemical analyzer was used to detect the indexes of organ function: aspartate aminotransferase (AST), creatinine (CK), creatine kinase (CK), platelet count (PLT) (BNP) level changes. Results After treatment, the levels of PCT and Treg cells in the two groups were significantly lower than those before treatment, and the observation group was lower than the control group. The levels of AST, Scr, CK-MB and BNP in the observation group were significantly lower than those in the control group Which was significantly higher than that of the control group (P <0.05). Conclusion Qishen Huoxue Granule can reduce the serum procalcitonin level in children with pneumonia complicated with sepsis and reduce the proportion of CD + 4 CD + 25 regulatory T lymphocytes in peripheral blood and play a protective role on the function of organs.