目的 探讨血必净注射液联合利奈唑胺葡萄糖注射液治疗脓毒症的临床疗效。方法 选取2021年6月—2023年6月在宜兴市第六人民医院就诊的82例脓毒症患者作为研究对象，按照计算机随机排列法将所有患者分为对照组和治疗组，各有41例。对照组静脉滴注利奈唑胺葡萄糖注射液，600 mg/次，1次/12 h。治疗组在对照组基础上静脉滴注血必净注射液，50 mL加入100 mL的生理盐水中，在30～40 min输注完毕，2次/d。两组患者连续治疗10 d。观察两组临床疗效，并比较两组治疗后的症状恢复时间、病情程度、外周血管阻力指数（SVRI）、每搏指数变异度（SVV）、血管外肺水指数（ELVWI）以及CD163、高迁移率族蛋白B1（HMGB1）、中性粒细胞/淋巴细胞的比值（NLR）的变化。结果 治疗后，治疗组的总有效率达87.80%，对照组总有效率为68.29%，组间对比差异具有统计学意义（P＜0.05）。治疗后，治疗组患者完成复苏时间、血压复常时间、体温恢复时间均比对照组短，差异有统计学意义（P＜0.05）。治疗后，两组的急性生理学与健康状况评分量表（APACHE II）评分明显低于治疗前（P＜0.05），且治疗组APACHE II评分较对照组更低，差异有统计学意义（P＜0.05）。治疗后，两组的SVRI、SVV、ELVWI低于治疗前（P＜0.05）；治疗后，治疗组的SVRI、SVV、ELVWI低于对照组，差异有统计学意义（P＜0.05）。治疗后，两组的血清CD163、HMGB1水平、NLR低于治疗前（P＜0.05）；治疗后，治疗组的血清CD163、HMGB1水平、NLR低于对照组，差异有统计学意义（P＜0.05）。结论 血必净注射液联合利奈唑胺葡萄糖注射液可提高脓毒症的治疗效果，促进患者复苏，减轻病情严重程度，改善患者的心排出量，降低炎症程度。

Objective To investigate the clinical effect of Xuebijing Injection combined with Linezolid and Glucose Injection in treatment of sepsis. Methods Patients (82 cases) with sepsis in Yixing City Sixth People’s Hospital from June 2021 to June 2023 were divided into control and treatment groups according to the computer random arrangement method, and each group had 41 cases. Patients in the control group were iv administered with Linezolid and Glucose Injection, 600 mg/time, once every 12 h. Patients in the treatment group were po administered with Xuebijing Injection on the basis of the control group, 50 mL added into normal saline 100 mL, the infusion was completed within 30 — 40 min, twice daily. Patients in two groups were treated for 10 d. After treatment, the clinical efficacies were evaluated, and the symptom recovery time, disease severity, SVRI, SVV, ELVWI, CD163, HMGB1, and NLR in two were compared. Results After treatment, the total effective rate of the treatment group was 87.80%, while that of the control group was 68.29%, and the difference was statistically significant (P < 0.05). After treatment, the recovery time, blood pressure normalization time, and temperature recovery time of the treatment group were shorter than those of the control group, and the difference was statistically significant (P < 0.05). After treatment, APACHE Ⅱ score of two groups was significantly lower than that before treatment (P < 0.05). After treatment, APACHE Ⅱ score of the treatment group was significantly lower than that of the control group, the difference was statistically significant (P < 0.05). After treatment, SVRI, SVV, and ELVWI of two groups were lower than those before treatment (P< 0.05). After treatment, SVRI, SVV, and ELVWI of the treatment group were lower than those of the control group, and the difference was statistically significant (P < 0.05). After treatment, the serum levels of CD163, HMGB1 and the NLR in two groups were lower than those before treatment (P< 0.05), and the serum levels of CD163, HMGB1 and the NLR of the treatment group were lower than those of the control group, and the difference was statistically significant (P < 0.05). Conclusion Xuebijing Injection combined with Linezolid and Glucose Injection can improve the treatment effect of sepsis, promote the recovery of patients, reduce the severity of the disease, improve the cardiac output of patients, and reduce the degree of inflammation.

R976

江苏省卫生健康委科研课题（Z2018011）