目的 观察并探讨血必净注射液联合乌司他丁对重症脓毒症患者血清因子、T细胞亚群及D-二聚体的影响。方法 入选2014年1月—2016年3月收治的150例脓毒症患者为研究对象，随机分为研究组和对照组各75例，对照组在抗感染、抗凝、氧疗等综合治疗基础上使用乌司他丁注射液，研究组在对照组基础上联合静滴血必净注射液，7 d为1疗程，记录并比较两组治疗前与治疗7 d后血清因子、T细胞亚群及D-二聚体水平变化与多器官功能障碍综合征（MODS）发生率及7 d病死率。结果 研究组治疗7 d后肿瘤坏死因子-α（TNF-α）、白介素-6（IL-6）、C反应蛋白（CRP）、降钙素原（PCT）水平均显著低于对照组（P<0.05）。研究组治疗后CD³⁺、CD⁴⁺、CD⁴⁺/CD⁸⁺均显著高于对照组（P<0.05）。研究组治疗后D-dimer、APACHEⅡ评分均显著低于对照组水平（P<0.05）；研究组7 d内MODS发生率（13.3% vs 20.0%）与病死率（10.7% vs 13.3%）低于对照组，但差异均无统计学意义。结论 乌司他丁治疗重症脓毒症基础上联合使用血必净注射液能进一步抑制炎症反应，调节细胞免疫功能，减轻高凝状态。

Objective To observe the influences of Xuebijing injection combined with UTI on variations of serum factor, T cell subsets and D-dimer for severe sepsis patients. Methods 150 severe sepsis patients from January 2014 to March 2016 were selected and randomly divided into study group and control group, each with 75 cases, based on conventional therapy control group added with UTI injection for 7d,observation group jointly added with Xuebijing injection, variations of inflammatory factor, T cell subsets and D - dimer levels before and 7d after treatment were noted,and MODS incidence and 7 d mortality ratio of the two groups were compared. Results The study group after treatment with TNF-α, IL-6, CRP, PCT were significantly lower than the control group (P<0.05). CD³⁺, CD⁴⁺, CD⁴⁺/CD⁸⁺ of study group after treatment were significantly higher than the control group (P<0.05). D-dimer and APACHEⅡ score of study group after treatment were significantly lower than the control group (P<0.05). MODS incidence rate (13.3% vs.20.0%) and mortality ratio (10.7% vs.13.3%) of study group within 7d were both lower than the control group, but the difference were not significant. Conclusion Based on UTI treatment for severe sepsis, Xuebijing injection added can further suppress inflammatory response, regulate cell immune function, alleviate the hypercoagulable state.

秦皇岛市科技支撑计划项目（201401A197）