Statin Drugs On Blood Coagulation In Sepsis-a Retrospective Analysis Of The Inflammatory Network And Proprietary Situation

ObjectiveTo observe the role of statins in patients with septic shock, and understand its influence on the 7 days mortality of septic shock patients, and the relation of inflammation, blood coagulation and lipid between used statins and un-uesed statins group. To compare the two groups among inflammation, blood coagulation and lipid in septic shock patients, when they were admission to hospital. We hope to improve the level of coagulation and inflammation in septic shock patients, understand the pathophysiologic process of septic shock, especially the relation of inflammation and coagulation in septic shock and the influence of lipid in septic pathophysiologic process. To achieve the end of reducing mortality in septic shock patients.MethodBy finding the Guangdong Provincial Hospital in January 2012-December 2014 admission diagnosis of septic shock patients, the general population by collecting clinical data,7-day mortality (less than seven days after discharge of follow-up), inflammatory markers (PCT, CRP), coagulation (APTT, AT, INR, FIB, PT), serum lipids (HLD-C, LDL-C) and Chinese medicine use categories and treatment of clinical data, and find and hospital two weeks ago whether admission taking statins, according to whether taking statins, statin drugs into groups, did not use statin group. Using SPSS 18.0 statistical analysis to compare whether the statin group using two sets of inflammatory markers (PCT, CRP), coagulation (APTT, AT, INR, FIB, PT), lipids (HLD-C, LDL-C) the difference, and 7 days mortality in patients with septic shock and death factors influence 7 days logistic regression analysis, made the conclusion.ResultThe study included 625 cases of qualified patients using statin group, the mortality rate of less than 7 days, did not use statin group (2,2% vs.17.3%, P= 0.001), further study found that use of statin group PCT levels on admission than those without the use of the first statin group (0.22 ± 0.09 vs.0.19 ± 0.10, P= 0.03); and in the coagulation parameters PT, the former than the latter using statin group (14.41 ± 4.88 vs.15.37 ± 5.61; P-0.004). Inflammatory markers CRP, PCT levels and APTT, AT, FIB correlation (P<0.05), which has a high degree of correlation of CRP and FIB. The lipid parameters HDL-C, LDL-C levels and inflammatory markers CRP, PCT levels, coagulation APTT, AT, PT, INR levels were correlated. PCT (OR= 0.004, P= 0.013), AT (OR= 0.985, P= 0.043), independent predictors of death in patients with septic shock within 7 days. In 625 cases of infectious shock patients collected using proprietary ratio reached 59.2 percent, while the use Xuebijing of 101 cases; Shenfu 92 cases, the two accounted for 52.2%.ConclusionLong-term use of statins in patients with septic shock can reduce mortality in seven days, the pathophysiological process of coagulation-related inflammation networks, also may be involved in lipid or blood coagulation in patients with sepsis-inflammation of network regulation. However, the standard treatment is a statin generally applicable to patients with septic shock, or apply only to abnormal lipid metabolism in patients with septic shock needs further study. And sepsis medicine usage aspect, variety, lack of consistent use of standardized intervention, how can we make good use of Chinese medicine treatment for sepsis, which require further evidence-based medical research.