黄芪注射液对脓毒症患者心肌损伤干预作用的观察  

An investigation of intervention of Radix astragali injection （黄芪注射液） on critically ill patients with septic myocardial injury

作　　者：胡雪珍[1] 卢中秋[2] 李志涛[1] 龚裕强[1] 孙来芳[1] 王征[1] 瞿晨初[1] 曾霜[1] 

机构地区：[1]温州医学院附属第二医院EICU,浙江温州325027 [2]温州医学院附属第～医院急救中心,浙江温州325000

出　　处：《中国中西医结合急救杂志》2010年第6期346-348,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：基金项目：浙江省医学重点扶植建设计划项目（07F04）;浙江省温州市科技计划项目（Y20080088）

摘　　要：目的 探讨黄芪注射液对伴发心肌损伤脓毒症患者受损心肌的干预作用.方法 将55例脓毒症及脓毒性休克伴发心肌损伤患者随机分为对照组（25例）及治疗组（30例）.对照组采用极化液治疗,治疗组在对照组基础上加用黄芪注射液30 ml静脉滴注,每日1次,两组均连用2周.观察两组患者治疗后1、5、10 d血肌钙蛋白I（cTnI）及心功能变化情况.结果 对照组各时间点血cTnI水平无明显变化;治疗组治疗后5 d、10 d cTnI水平均较治疗1 d明显降低,且明显低于对照组[5 d：（0.83±0.60） μg/L比（1.50±1.48） μg/L,10 d：（0.61±0.52） μg/L比（1.26±1.23） μg/L,均P＜0.05].36例存活者治疗5 d、10 d cTnI水平明显低于19例死亡者[5 d：（0.67±0.49） μg/L比（1.61±1.40） μg/L,10 d：（0.52±0.45） μg/L比（1.32±1.17） μg/L,均P〈0.05].治疗组和对照组心肌抑制发生率及治疗前局部室壁运动/左室舒张期充盈（E/A）比较差异无统计学意义;治疗2周后治疗组E/A较对照组明显升高（1.4±0.3比1.1±0.2）,且心肌抑制恢复时间明显短于对照组[室壁运动恢复时间：（7.0±0.6） d比（11.0±0.8） d,左室舒张功能恢复时间：（4.0±0.5） d比（8.0±0.8） d,P〈0.05或P＜0.01].结论 黄芪注射液对脓毒症患者受损心肌有较强的保护作用,可提早恢复受抑制心肌的功能.Objective To study the effects of Radix astragali injection （黄芪注射液） on injured myocardium in severe septic patients with myocardial injury. Methods Fifty-five patients clinically diagnosed as severe sepsis/sepsis shock were randomly divided into a treatment group （30 cases） and a control group （25 cases）. The polarized solution was used in both groups, and the Radix astragali injection 30 ml intravenous drip was additionally used in the treatment group once a day. Sequentially, the course of treatment of two groups was 2 weeks. The level of cardiac tropinin I （cTnI） and the cardiac functions of the 1, 5 and l0 days after treatment were observed. Results At the time points of 1, 5 and 10 days, the levels of cTnI of the control group did not change obviously. In the treatment group, the levels of cTnI on 5 days and 10 days were more descended than the level on 1 day obviously. The levels of cTnI were more decreased in the treatment group than those in the control group significantly （5 days： （0.83 ±0.60） μg/L vs. （1.50±1.48）μg/L, 10 days： （0. 61±0. 52）μg/L vs. （1.26±1.23） /lg/L, both P〈0. 05]. The levels of eTnI of the 36 survival patients were lowered more than those of the 19 dead patients markedly （5 days： （0.67± 0.49）μg/L vs. （1.61±1. 40） μg/L, 10 days： （0. 52±0. 45） μg/L vs. （1.32±1.17）μg/L, both P〈0. 05]. No statistic differences were found in two groups with the myocardial depression incidence and the ratio of the mitral annular diastole （E） and late diastole （A） inflow velocities （E/A） before the treatment. After 2-week therapy, the E/A was higher in treatment group than that in control group （1.4±0. 3 vs. 1.1±0. 2）, and the recovery time of cardiac depression was shorter in the treatment group than that of the control group [the regional wall motion recovery time： （7.0± 0. 6） days vs. （11.0± 0. 8） days, the left ventricular diastolic function recovery time： （4.0±0.5） days vs. （8.0

关 键 词：脓毒症 心肌损伤 肌钙蛋白 心肌抑制 黄芪注射液 

分 类 号：R285.6[医药卫生—中药学] R256.2[医药卫生—中医学]