目的 探讨血必净注射液联合利巴韦林治疗重症病毒性肺炎的临床疗效。方法 纳入2021年1月—2023年12月安徽理工大学第一附属医院ICU诊断为重症病毒性肺炎患者86例，采用计算机生成随机数字表，将患者按照入组顺序随机分为对照组38例和治疗组36例。对照组静脉滴注利巴韦林注射液，0.5 g加入0.9%氯化钠溶液250 mL，1次/d。治疗组在对照组治疗基础上静脉滴注血必净注射液，50 mL/次，2次/d。两组均连续治疗2周。观察两组临床疗效、一般临床指标、肺部影像学改善情况、实验室相关指标。结果 治疗后，治疗组和对照组总有效率分别是91.67%、81.58%，两组比较差异无统计学意义。与对照组相比，治疗组临床恢复时间、退热时间、平均住院时间均显著短于对照组，而肺部影像学改善率、临床康复率显著高于对照组（P＜0.05）。治疗后，两组淋巴细胞、C反应蛋白（CRP）、降钙素原、肌酸激酶MB（CK-MB）水平均较同组治疗前显著降低（P＜0.05）；治疗后，治疗组淋巴细胞、CRP、降钙素原、CK-MB水平低于对照组（P＜0.05）。结论 血必净注射液联合利巴韦林治疗重症病毒性肺炎具有显著疗效，能够有效改善患者的肺部炎症反应，缩短临床症状恢复时间及住院时间，加快康复进程，安全性较好。

Objective To investigate the clinical effect of Xuebijing Injection combined with ribavirn in treatment of severe viral pneumonia. Methods A total of 86 patients diagnosed with severe viral pneumonia in the ICU of the First Affiliated Hospital of Anhui University of Science and Technology from January 2021 to December 2023 were included. A computer-generated random number table was used to randomly divide the patients into control group (38 cases) and treatment group (36 cases) according to the order of admission. Patients in the control group were iv administered with Ribavirn Injection, 0.5 g was added to 0.9% sodium chloride solution 250 mL, once daily. Patients in the treatment group were iv administered with Xuebijing Injection on the basis of the control group, 50 mL/time, twice daily. Both groups were treated continuously for 2 weeks. The clinical efficacy, general clinical indexes, lung imaging improvement and laboratory related indexes of the two groups were observed. Results After treatment, the total effective rate of the treatment group and control group was 91.67% and 81.58%, respectively, and there was no statistical significance between two groups. Compared with control group, the clinical recovery time, fever remission time and average hospital stay in treatment group were significantly shorter than those in the control group, but the lung imaging improvement rate and clinical recovery rate was significantly higher than those in control group (P < 0.05). After treatment, the levels of lymphocyte, C-reactive protein (CRP), procalcitonin and creatine kinase MB (CK-MB) in two groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the levels of lymphocyte, CRP, procalcitonin and CK-MB in treatment group were lower than those in control group (P < 0.05). Conclusion Xuebijing Injection combined with ribavirn has significant efficacy in treatment of severe viral pneumonia, and can effectively improve the pulmonary inflammatory response of patients, shorten the recovery time of clinical symptoms and hospital stay, accelerate the rehabilitation process, which has good safety.

R974