中国临床药理学杂志

氢化可的松联合连续性血液净化治疗脓毒症患者的临床研究

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李锋 ^1a , 朱陈强 ^1b , 王刚 ^1c , 张喆 ^1a

中国临床药理学杂志 | 临床与基础桥接研究 2025,41(2): 174-177

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中国临床药理学杂志 |临床与基础桥接研究 2025 , 41 (2) : 174 -177

氢化可的松联合连续性血液净化治疗脓毒症患者的临床研究

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李锋^1a, 朱陈强^1b, 王刚^1c, 张喆^1a

作者信息

^1a.杭州市临平区第一人民医院，急诊医学科，浙江杭州 311100

^1b.杭州市临平区第一人民医院，重症医学科，浙江杭州 311100

^1c.杭州市临平区第一人民医院，心血管内科，浙江杭州 311100

通讯作者:

张喆，副主任医师 Tel: （0571）89369046 E-mail: zhan074892@163.com

作者简介:

李锋（1985-），男，副主任医师，主要从事急危重症方向的临床诊疗工作与研究

Clinical trial of hydrocortisone combined with continuous blood purification in the treatment of sepsis patients

Feng LI^1a, Chen-qiang ZHU^1b, Gang WANG^1c, Zhe ZHANG^1a

Affiliations

^1a.Department of Emergency Medicine, First People’s Hospital of Linping District, Hangzhou, Hangzhou 311100, Zhejiang Province, China

^1b.Department of Intensive Care Unit, First People’s Hospital of Linping District, Hangzhou, Hangzhou 311100, Zhejiang Province, China

^1c.Department of Cardiovascular Medicine, First People’s Hospital of Linping District, Hangzhou, Hangzhou 311100, Zhejiang Province, China

出版时间: 2025-01-28 doi: 10.13699/j.cnki.1001-6821.2025.02.005

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摘要

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目的

观察氢化可的松注射剂联合连续性血液净化治疗脓毒症患者的临床疗效和安全性。

方法

将脓毒症患者随机分为对照组与试验组。对照组给予连续性血液净化治疗；试验组在对照组治疗的基础上，联合氢化可的松200 mg，qd，静脉滴注。2组患者均连续治疗1周。比较2组患者的临床疗效、炎性因子、细胞免疫功能和安全性。

结果

试验组入组56例，脱落5例，最终有51例纳入统计分析；对照组入组55例，脱落4例，最终有51例纳入统计分析。治疗后，试验组和对照组的总有效率分别为94.12%（48例/51例）和74.51%（38例/51例），在统计学上差异有统计学意义（P<0.05）。治疗后，试验组和对照组的C-反应蛋白水平分别为（12.21±2.35）和（15.18±2.25）mg·L^-1，降钙素原水平分别为（0.49±0.13）和（0.78±0.21）ng·mL^-1，CD₃⁺水平分别为（58.72±5.13）%和（54.21±4.47）%，CD₄⁺/CD₈⁺比值分别为1.71±0.23和1.43±0.17，在统计学上差异均有统计学意义（均P<0.05）。试验组的药物不良反应主要有胸闷、恶心、呕吐，对照组的药物不良反应主要有低血压、恶心、呕吐。试验组和对照组的总药物不良反应发生率分别为9.80%和5.88%，在统计学上差异无统计学意义（P>0.05）。

结论

氢化可的松注射剂联合连续性血液净化治疗脓毒症患者的临床疗效显著，其能够更好地改善患者的免疫功能，减轻炎症反应，且不增加药物不良反应的发生率。

关键词

氢化可的松注射剂 / 连续性血液净化 / 脓毒症 / 炎症反应 / 细胞免疫功能 / 安全性评价

Abstract

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Objective

To observe the clinical efficacy and safety of hydrocortisone injection combined with continuous blood purification in the treatment of sepsis patients.

Methods

Sepsis patients were randomly divided into control group and treatment group. The control group received continuous blood purification treatment; on the basis treatment of control group, the treatment group received hydrocortisone 200 mg, qd, intravenous infusion. Two groups were treated for 1 week. The clinical efficacy, levels of inflammatory cytokines, cellular immune function indicators, and safety were compared between two groups.

Results

Fifty-six cases were enrolled in the treatment group, 5 cases were excluded, and ultimately 51 cases were included in the statistical analysis. Fifty-five cases were enrolled in the control group, 4 cases were excluded, and ultimately 51 cases were included in the statistical analysis. After treatment, the total effective rates of the treatment and control groups were 94.12% (48 cases/51 cases) and 74.51% (38 cases/51 cases) with statistical significant difference (P<0.05). After treatment, the levels of C-reactive protein in the treatment and control groups were (12.21±2.35) and (15.18±2.25) mg·L^-1, the levels of procalcitonin were (0.49±0.13) and (0.78±0.21) ng·mL^-1, the levels of CD₃⁺ were (58.72±5.13)% and (54.21±4.47)%, the CD₄⁺/CD₈⁺ ratios were 1.71±0.23 and 1.43±0.17, respectively. The differences were statistically significant (all P<0.05). The adverse drug reactions of treatment group were chest tightness, nausea, and vomiting, while those in the control group were hypotension, nausea, and vomiting. The total incidences of adverse drug reactions in the treatment and control groups were 9.80% and 5.88%, without significant difference (P>0.05).

Conclusion

Hydrocortisone injection combined with continuous blood purification have a definitive clinical efficacy in the sepsis patients, which can improve the patients’ immune function, reduce inflammatory reactions, without increasing the incidences of adverse drug reactions.

Key words

hydrocortisone injection / continuous blood purification / sepsis / inflammatory response / cellular immune function / safety evaluation

引用本文

李锋, 朱陈强, 王刚, 张喆. 氢化可的松联合连续性血液净化治疗脓毒症患者的临床研究. 中国临床药理学杂志, 2025 , 41 (2) : 174 -177 . DOI: 10.13699/j.cnki.1001-6821.2025.02.005

Feng LI, Chen-qiang ZHU, Gang WANG, Zhe ZHANG. Clinical trial of hydrocortisone combined with continuous blood purification in the treatment of sepsis patients[J]. Chinese Journal of Clinical Pharmacology, 2025 , 41 (2) : 174 -177 . DOI: 10.13699/j.cnki.1001-6821.2025.02.005

基金

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浙江省医药卫生科技计划基金资助项目(2024XY128)

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2025年第41卷第2期

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文章信息

doi: 10.13699/j.cnki.1001-6821.2025.02.005

接收时间：2024-07-21
首发时间：2026-08-04
出版时间：2025-01-28

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收稿日期：2024-07-21

基金

浙江省医药卫生科技计划基金资助项目(2024XY128)

作者信息

^1a.杭州市临平区第一人民医院，急诊医学科，浙江杭州 311100

^1b.杭州市临平区第一人民医院，重症医学科，浙江杭州 311100

^1c.杭州市临平区第一人民医院，心血管内科，浙江杭州 311100

通讯作者:

张喆，副主任医师 Tel: （0571）89369046 E-mail: zhan074892@163.com

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https://castjournals.cast.org.cn/joweb/zglcylxzz/CN/10.13699/j.cnki.1001-6821.2025.02.005

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

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