痰热清灌洗治疗重症脑梗死并发肺部感染的疗效及对血清炎症因子和氧化应激的影响

Clinical effect of severe cerebral infarction complicated with pulmonary infection and impact on plasma inflammatory factors and oxidative stress

摘要:

摘要： 目的 观察分析利用痰热清灌洗治疗方法对重症脑梗死并发肺部感染的临床疗效及对血清炎症因子和氧化应激的影响。方法 按照随机抽样方法，把患有重症脑梗死并发肺部感染的60名患者分为两个组。其中治疗组及对照组各30例，两组均给予常规内科综合治疗及纤维支气管镜肺泡灌洗治疗，对照组在此基础上采用生理盐水进行灌洗，治疗组则在对照组基础上进一步加用痰热清注射液对肺泡进行灌洗，两组均连续治疗7d。对两组患者临床症状改善时间进行比较；观察两组治疗前及治疗后3和7d的氧化应激指标[超氧化物歧化酶（SOD）和丙二醛（MDA）]、血清炎症因子[白细胞介素-1β（IL-1β）、白细胞介素-8（IL-8）、降钙素原（PCT）和C-反应蛋白（CRP）]、血气指标[动脉血氧分压（PaO2）、动脉血氧饱和度（SaO2）、动脉血二氧化碳分压（PaCO2）和乳酸浓度（Lac）]、美国国立卫生研究院卒中量表（NIHSS）和临床肺部感染评分（CPIS）的变化情况，并利用统计学软件进行统计分析。结果 两组临床症状均明显改善（P<0.05），治疗组明显优于对照组（P<0.05）；两组治疗后3和7d血清SOD升高，MDA水平、血清炎症因子（IL-1β、IL-8、CRP和PCT）、NIHSS评分和CPIS评分均明显降低，血气指标（PaO2、SaO2、PaCO2和Lac）明显改善，差异均有统计学意义（P<0.05），且治疗组上述指标改善情况明显优于对照组（P<0.05）。结论 痰热清注射液支气管肺泡灌洗治疗重症脑梗死伴有肺部感染可以明显降低其炎症指标，有效控制感染，改善呼吸功能，并有助于调节氧化应激指标，从而促进患者脑功能恢复。

Abstract:

Abstract: Objective To observe and analyze the clinical curative effect of sputum heat cleaning and irrigation treatment on severe cerebral infarction complicated with pulmonary infection and impact on serum inflammatory factors and oxidative stress.Methods According to the random sampling method, 60 patients with severe cerebral infarction complicated with pulmonary infection were divided into two groups, the treatment group and control group, 30 patients in each. Patients in the two groups were given conventional medicine comprehensive treatment and fiber bronchoscope alveolar lavage treatment, the control group on the basis of lavage with saline solution, and the treatment group is in the control group on the basis of further with phlegm heat injection on alveolar lavage, the two groups are continuous treatment for 7 d. Then the clinical symptoms of the two groups were compared; to observe the two groups before and after treatment of 3 d, 7 d oxidative stress indicators (SOD, MDA), serum levels of inflammatory cytokines (IL-1 beta, IL- 8, PCT and CRP), blood gas index (PaO2, SaO2, PaCO2, Lac) and NIHSS, CPIS score changes, and make use of statistical software for statistical analysis.Results The clinical symptoms of the two groups were significantly improved (P<0.05), and the treatment group was significantly better than the control group (P<0.05). The serum superoxide dismutase (SOD), malondialdehyde (MDA) level after treatment for 3 d, 7 d in the two groups were elevated and serum inflammatory cytokines (IL-1 beta, IL-8, CRP and PCT), NIHSS score, CPIS score were significantly lower, blood gas index (PaO2, SaO2, PaCO2, Lac) improved significantly, with statistical significance (P<0.05), and the above indexes improvement in treatment group was obviously better than that of the control group (P<0.05).Conclusion Phlegm heat injection bronchoalveolar lavage treatment of severe cerebral infarction accompanied by pulmonary infection can significantly reduce inflammation index, effective control of infection and improve respiratory function, and helps to regulate the oxidative stress index, promote brain function in patients with recovery.