丹参川芎嗪注射液对重度烧伤患者早期心肌损害的影响  

Effect of salvia miltiorrhiza and ligustrazine injection on the early myocardial damage of patients with severe burn

作　　者：丁羚涛[1] 朱宇刚[1] 顾在秋[1] 蔡良良[1] 彭京梁[1] 吕国忠[1] 

机构地区：[1]南通大学第三附属医院（无锡市第三人民医院）烧伤整形科,江苏省无锡市214041

出　　处：《中华烧伤杂志》2012年第3期170-172,共3页Chinese Journal of Burns

摘　　要：目的观察丹参川芎嗪注射液对重度烧伤患者早期心肌损害的影响。方法将2010年1月-2011年8月笔者单位收治的20例烧伤总面积大于或等于50％TBSA的患者按照住院先后顺序编号并分为2组，单数号进入治疗组、双数号进人对照组，每组10例。对照组患者人院后进行常规治疗，包括采用第三军医大学公式补液复苏、抗感染、支持治疗、器官保护治疗等。治疗组在对照组治疗基础上将10mL丹参川芎嗪注射液加入250mL葡萄糖注射液（50g／L）中进行静脉滴注，每日1次、连用3d。于伤后12、24、48、72h分别抽取2组患者静脉血，测定各时相点血浆中心肌肌钙蛋白I（cTnI）、心肌型肌酸激酶同工酶（CK-MB）以及心钠素水平。对数据进行t检验。结果治疗组患者各时相点cTnI、CK-MB、心钠素检测值均低于对照组，2组比较，大部分时相点差异有统计学意义，t值为2．136-2．918，P〈0．05或P〈0．01。伤后12h，2组患者上述指标水平均处于峰值，治疗组分别为（28±10）ng／mL、（76±13）U／L、（430±87）pg／mL，对照组分别为（38±11）ng／mL、（87±10）U／L、（453±91）pg／mL。伤后24-72h，2组患者上述指标水平均逐渐下降。结论重度烧伤后早期应用丹参川芎嗪注射液，可以有效减轻患者心肌细胞损害，起到保护心肌的作用。Objective To observe the effect of salvia miltiorrhiza and ligustrazine injection on the early myocardial damage of severely burned patients. Methods Twenty severely burned patients hospital- ized from January 2010 to August 2011 , with burn area equal to or more than 50% TBSA, were divided into two groups following hospitalization sequence, with odd number patients entering treatment group （T, n = 10） and even number patients entering control group （ C, n = 10）. Patients in C group were treated with routine methods, including fluid resuscitation based on the Third Military Medical University formula, anti- infection treatment, support treatment, and organ-protection treatment, etc. In addition to routine treatment methods, patients in T group received intravenous infusion of 250 mL glucose injection （50 g/L） containing 10 mL salvia mihiorrhiza and ligustrazine concoction, once a day, and continued for three days. Venous blood of patients was drawn at post burn hour （PBH） 12, 24, 48, and 72 to determine the plasma levels of cardiac troponin I （cTnI） , ereatine kinase isozyme MB （CK-MB） , and atrial natriuretic peptide （ANP）. Data were processed with t test. Results At each time point, levels of cTnI, CK-MB, and ANP were low- er in T group than in C group. Differences in contents of these parameters between two groups were statisti- cally significant at most time points, with t values from 2. 136 to 2. 918, P 〈 0.05 or P 〈 0.01. Plasma lev- els of cTnI, CK-MB, and ANP in both groups peaked at PBH 12, which were respectively （28 ± 10） ng/mL, （76 ±13） U/L, （430 ±87） pg/mL in T group, and （38 ± 11） ng/mL, （87± 10） U/L, （453±91） pg/mL in C group. From PBH 24 to 72, contents of above-mentioned parameters decreased gradually in both groups. Conclusions Early use of salvia miltiorrhiza and ligustrazine injection in severely burned patients can effectively reduce myocardial damage, thus protect the myocardium from injury.

关 键 词：烧伤 心肌 肌钙蛋白 肌酸激酶 MB型 心钠素 丹参 川芎嗪 

分 类 号：R269[医药卫生—中西医结合]