Effect of Xuebijing injection on systemic inflammatory response and immune function of patients with acute exacerbation of severe chronic obstructive pulmonary disease
10.3969/j.issn.1008-9691.2015.02.016
- VernacularTitle:血必净注射液对重症慢性阻塞性肺疾病急性加重期患者全身炎症反应及免疫功能的影响
- Author:
Ling LUO
;
Ling PAN
- Publication Type:Journal Article
- Keywords:
Acute exacerbation of chronic obstructive pulmonary disease;
Xuebijing injection;
Systemic inflammatory response;
Immune function
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2015;26(2):173-177
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the impacts of Xuebijing injection on systemic inflammatory response and immune function of patients with acute exacerbation of severe chronic obstructive pulmonary disease (AECOPD). Methods A prospective randomized controlled trial (RCT) was conducted. Forty patients with severe AECOPD were divided into control group and Xuebijing group in accordance with the random number table, each group 20 cases. Both groups were treated by routine conventional basic therapy of severe AECOPD including anti-infection, phlegm-expelling formula, bronchodilators and mechanical ventilation, etc, while in Xuebijing group, intravenous drip of Xuebijing (100 mg, twice a day for 5 days) was additionally used. The changes of data of arterial blood gas analysis, blood routine examination, C-reactive protein (CRP), procalcitonin (PCT), immune function, and acute physiology and chronic health evaluation system Ⅱ (APACHE Ⅱ) score before and after therapy were observed and compared between the two groups. The length of stay in hospital, duration of mechanical ventilation, and prognosis were also compared between the two groups. Besides, according to the difference in APACHE Ⅱ score, all the patients were divided into APACHEⅡscore≥15 score group (18 cases) and APACHEⅡscore<15 score group (22 cases), and the immune function were compared between the two groups. Results ①The immune function was descended and disordered in patients with severe AECOPD. Compared with the < 15 score group, the expressions of CD45+, CD3+, CD4+, CD4+/CD8+ ratio, B-lymphocyte, natural killer cell (NK cell) in ≥ 15 score group were significantly lowered [CD45+(×106/L):663.92±100.61 vs. 1 289.92±169.38, CD3+(×106/L):342.05±108.93 vs. 882.37±172.56, CD4+(×106/L):205.96±63.97 vs. 486.24±108.64, CD4+/CD8+ratio:0.76±0.49 vs. 1.32±0.57, B-lymphocyte (×106/L):124.77±32.72 vs. 166.06±48.02, NK cells (×106/L): 186.47±39.57 vs. 243.51±44.72, all P < 0.05]. There was no statistically significant difference in the expression of CD8+ between the ≥ 15 score group and < 15 score group (P > 0.05). ② Compared with those before therapy, the pH value, oxygenation index, arterial partial pressure of carbon dioxide (PaCO2), white blood cell count (WBC), CRP, PCT were significantly improved after therapy in both control and Xuebijing groups. Compared with those in the control group, WBC, CRP, PCT were significantly lowered in Xuebijing group [WBC (×109/L): 10.29±3.83 vs. 12.69±3.42, CRP (mg/L): 9.06±4.19 vs. 15.26±4.22, PCT (ng/L): 0.18±0.21 vs. 0.42±0.24, all P < 0.05]. There were no statistically significant differences in pH value, oxygenation index and PaCO2 between two groups (all P>0.05). The degrees of improvement of CD45+, CD3+, CD4+, CD8+ and CD4+/CD8+ ratio were more remarkable in Xuebijing group after treatment than those in control group [CD45+ (×106/L): 1 079.38±153.86 vs. 1 015.63±157.11, CD3+ (×106/L): 652.05±100.05 vs. 596.81±106.85, CD4+ (×106/L): 358.92±67.53 vs. 329.99±72.61, CD8+ (×106/L): 205.73±35.19 vs. 230.41±39.74, CD4+/CD8+ratio: 2.16±0.63 vs. 1.52±0.54, all P < 0.05]. The B-lymphocyte and NK cell before treatment and after treatment showed no statistical significant differences between the two groups (all P > 0.05). Compared with the control group, the duration of mechanical ventilation (hours: 56.25±22.87 vs. 69.45±26.59) and the length of stay in hospital (days: 11.00±0.74 vs. 14.00±2.06) were shortened, and APACHE Ⅱ score was significantly lowered in Xuebijing group (8.21±2.97 vs. 12.08±3.12, P < 0.05). The numbers of multiple organ failure and dead patients in Xuebijing group were less than those of control group, but no statistical significant differences were found (both P > 0.05). Conclusion Xuebijing injection for treatment of patients with severe AECOPD can ameliorate inflammatory response, improve immune function, shorten the duration of mechanical ventilation and the length of stay in hospital, and decrease the risk of death.
