Authors

Yu Gao, Feng Zheng, Hongwei Ye#, Yilan Wang, Weiyi Zhou, Jing Zhang

Departments

Changshu Hospital Affiliated to Soochow University, First People's Hospital of Changshu City, Changshu 215500, Jiangsu Province, China

Abstract

Objective: To observe the efficacy of Xuebijing combined with thrombolysis for pulmonary thromboembolism (PTE), and its effects on apelin-13, inflammatory factors and hemorheology.

Methods: 47 patients with high-risk PTE treated at the First People's Hospital of Changshu City from January 2013 to December 2019 were enrolled and divided into control group and observation group according to random number table. Both groups received thrombolysis using rt-PA. After its completion, unfractionated heparin sodium (UFH) was used for anticoagulant. On this basis, the observation group was treated with 100ml intravenous infusion of Xuebijing q12h for 7 days. The control group was treated with equal amount of normal saline. The two groups were compared before and at 3, 5, and 7 days after treatment in terms of oxygenation index, pulmonary arterial systolic pressure, apelin-13, TNF-α, IL-1, IL-6, IL-8, HMGB-1 levels and hemorheological indicators (low shear blood viscosity, high shear blood viscosity, RBC aggregation index, RBC deformation index, erythrocyte rigidity index, hematokrit, plasma viscosity and platelet aggregation rate). Also, APACHE-II score and incidence of bleeding events were compared between the two groups before and at 7 days after treatment.

Results: No such adverse reactions as allergies occurred in the two groups, and  no difference was shown in bleeding events (P﹥0.05). In different time windows after treatment, oxygenation index, pulmonary artery systolic pressure, apelin-13, TNF-α, IL-1, IL-6, IL-8, HMGB-1 levels of the observation group were statistically different from the control group (P﹤0.05), and the observation group had a lower APACHE-II score than the control group on the 7th day after treatment, showing statistical difference (P﹤0.05). In terms of hemorheology, the two groups showed no significant difference over time in terms of RBC deformation index, erythrocyte rigidity index, hematokrit and plasma viscosity (P﹥0.05), showing no statistical difference (P﹥0.05), and the observation group was statistically different from the control group under the same time window in terms of low shear blood viscosity, RBC aggregation index and platelet aggregation rate (P﹤0.05).

Conclusion: Xuebijing can better improve clinical indicators of high-risk PTE by regulating apelin-13, inhibiting inflammatory factors and adjusting hemorheology without increasing the risk of bleeding, thus safe and reliable.

Keywords

Xuebijing, Pulmonary embolism, apelin-13, Inflammatory factors, Hemorheology.

DOI:

10.19193/0393-6384_2020_3_326