The Effect Of Xuebijing On Blood Coagulation And Vascular Endothelial Function In Patients With Septic Shock

Objective: The severe stage of sepsis is septic shock,which is an organ infection caused by an imbalanced inflammatory response.Patients develop hemagglutination,micro-thrombus formation and microcirculation.The pathogenesis of septic shock is more complex,vascular endothelial function,inflammatory factors,apoptosis and coagulation dysfunction are closely related with.When the infection is severe,large number of inflammatory factors are produced in the body,which impairs endothelial function,further activates platelets and coagulation factor XII,initiates endogenous coagulation mechanisms,causes microthrombi to form in blood vessels,and causes microcirculatory disturbances,causing multiple organ damage.Seriously,it also induces multi-organ failure,leading to serious death.A large number of studies have found that the level of inflammatory cytokines,coagulation abnormalities and sepsis severity,mortality was positively correlated.Xuebijing injection consists of Safflower,Rhizoma Chuanxiong,Radix Salviae Miltiorrhizae,Angelicae Sinensis and Radix Paeoniae Alba,which has the effects of promoting blood circulation to remove blood stasis and clearing heat and toxic materials,and can remove inflammatory factors such as endotoxin,interleukin and tumor necrosis factor,improve cell hypoxia,lower blood Viscosity,regulate body immunity and other functions.In this study,Xuebijing injection combined with liquid resuscitation,antibiotics,insulin treatment,prevention of stress ulcer and nutrition support for the treatment of septic shock,observed changes in blood lactic acid,coagulation,endothelial function,and explore its septic Shock clinical curative effect.Methods: They were given liquid resuscitation,anti-infective antibiotics,vasoactive drugs,insulin and nutrition support immediately after admission in the control group,and they were given Xuebijing injection intravenously on the basis of the control group in the observation group.The changes of blood lactic acid,VEGF,ET-1,vWF,APTT,PT and platelet count before and after treatment were observed.Blood lactate levels were measured by plasma colorimetry.Platelet count using the United States Beckman ACL7000 automatic coagulation analyzer.The levels of VEGF,ET-1 and vWF were determined by enzyme-linked immunosorbent assay(ELISA).Results:1.The general situation of patientsControl group of 20 patients,including 10 males and 10 females,aged 51.20±10.08 years old,weighing 68.23 ± 10.73 kg,APACHEⅡ 25.16±2.12 score.18 cases in the observation group,including 8 males and 10 females,aged 53.67 ± 10.28 years,weighing 68.91 ± 10.29 kg,APACHEⅡ25.09±2.31 score.There was no significant difference between the two groups in general conditions(P>0.05).2.Comparison of coagulation between the two groupsThere was no significant difference in APTT and PT between the two groups before treatment(P>0.05).There was no significant difference in APTT and PT between the treatment of 1 day and 3 days(P>0.05).Treatment for 7 days,14 days after the observation group APTT,PT shortened,the difference was statistically significant(P<0.05).3.Platelet count comparisonThere were no significant differences in platelet count before and after treatment between the two groups(P<0.05).4.blood lactate levelsThere was no significant difference in blood lactate levels before and after treatment between the two groups(P>0.05)5.Vascular endothelial function comparisonThere was no significant difference in VEGF,ET-1 and vWF levels between the two groups before treatment,1 day and 3 days after treatment(P>0.05).After 7 and 14 days of treatment,the levels of VEGF,ET-1 and vWF in both groups decreased compared with those in the control group,but the decrease in the observation group was more significant than that in the control group(P<0.05).6.Hemodynamic changesThere was no significant difference in heart rate(HR),mean arterial pressure(MAP)and central venous pressure(CVP)between the two groups before treatment,1 day,3 days,7 days and 14 days after treatment(P>0.05).7 Survival rate comparisonA total of 10 deaths was 55.56% in the control group,a total of 8 deaths was 50.00% in the observation group.There was no significant difference between the two groups(P>0.05)Conclusion:1.Xuebijing injection can down-regulate the expression of VEGF,ET-1 and vWF and improve the endothelial function in patients with septic shock.2.Xuebijing Injection can increase the platelet count in patients with septic shock,APTT,PT shortened.3.Xuebijing injection can not improve the survival rate of patients with sepsis shock.