乌斯他丁联合参附注射液治疗脓毒症心肌损伤的疗效分析  

Protective Role of Ulinastatin Plus Shenfu Injection on Myocardial Injury in Severe Sepsis Patients

作　　者：刘丹[1] 刘晗喆[2] 周秀华[1] 

机构地区：[1]中国医科大学附属第四医院ICU病房,辽宁沈阳110032 [2]中国医科大学附属第四医院肾内科,辽宁沈阳110032

出　　处：《医学临床研究》2015年第9期1685-1687,共3页Journal of Clinical Research

基　　金：辽宁省科学技术基金项目（201102256）

摘　　要：【目的】探讨乌斯他丁联合参附注射液治疗脓毒症心肌损伤的疗效。【方法】将本院收治的70例急性生理学与慢性健康状况评分Ⅱ（APACHEⅡ）≥15分的脓毒症伴心肌损伤患者随机分为两组。对照组在常规治疗的基础上加用乌斯他丁静脉滴注，试验组在对照组基础上给予参附注射液静脉滴注，均连续治疗7d。两组分别于治疗1、3、7d后检测血浆氨基末端B型脑钠肽前体（NT-proBNP）水平、血清肌钙蛋白I（cTnI）的水平，同时记录并比较两组患者心指数（CI）、APACHEⅡ评分的变化。【结果】两组患者治疗1d后血浆NT-proBNP、cTnI、CI、A-PACHEII评分比较差异无显著性（P〉0．05）。治疗3、7d后试验组血浆NT～proBNP、cTnI、APACHEⅡ评分等较对照组明显下降，CI较对照组明显升高，且两组相比较差异有显著性（P〈0．05）。【结论】乌司他丁联合应用参附注射液对脓毒症的心肌损伤具有更明显的保护作用。[Objective] To explore the protective role of ulinastatin plus Shenfu Injection on myocardial injury in severe septic patients. [Methods] A total of 70 patients with sepsis and myocardial injury whose A- PACHE Ⅱ scores ≥15 were randomly divided into ulinastatin treatment group （control） and ulinastatin plus Shenfu Injection treatment group （observation）. The control group received ulinastatin treatment for 7 days while ulinastatin plus Shenfu Injection for 7 days in the observation group. Plasma NT-proBNP level, serum troponin I （cTnI） level, cardiac index （CI） and APACHEⅡ scores of patients were detected and evaluated at Day 1, 3 ＆7 post-treatment. [Results] No significant inter-group differences existed in plasma NT-proBNP level, serum cTnI level, CI and APACHE ]] scores at Day 1 after treatment （ P〈0.05）. The levels of plasma NT-proBNP and serum cTnI were significantly lower and the level of cardiac index was significantly higher than control group at Days 3 and 7 post-treatment （ P 〈0.05）. [Conclusion] Ulinastatin plus Shenfu Injection offers more benefits by energizing impaired myocardial cell directly.

关 键 词：胰蛋白酶抑制剂/治疗应用 附子/治疗应用 人参/治疗应用 注射剂 脓毒症/并发症 心肌疾病/病因学 心肌疾病/药物疗法 

分 类 号：R631.1[医药卫生—外科学]