血必净联合乌司他丁对脓毒症心肌损伤的保护效应  

Study on the protective effect of Xuebijing combined with ulinastatin on myocardial injury in sepsis

作　　者：卢静[1] 肖斌[1] 苏天生[1] 许钦[1] 李玮[2] LU jing1 , XIAO bin1 , SU tiansheng1 , XU qin1 , LI wei2(1. The Second People＇s Hospital Affiliated to Fujian University of TCM, Fuzhou 350003, Fujian, China; 2. The People＇ s Hospital Affiliated to Fujian University of TCM, Fuzhou 350004, Fujian, Chin)

机构地区：[1]福建中医药大学附属第二人民医院,福建福州350003 [2]福建中医药大学附属人民医院,福建福州350004

出　　处：《现代中西医结合杂志》2018年第24期2653-2656,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨血必净联合乌司他丁对脓毒症心肌损伤患者的影响及其可能机制。方法随机将83例脓毒症心肌损伤患者分为对照组18例、乌司他丁组20例、血必净组20例、联合组25例。对照组按照脓毒症治疗指南进行常规治疗。在对照组常规治疗基础上,乌司他丁组加用乌司他丁40万IU静脉推注,每12 h 1次,连用5 d;血必净组加用血必净注射液100 mL静脉滴注,每12 h 1次,连用5 d;联合组给予乌司他丁40万IU静脉推注+血必净注射液100 mL静脉滴注,均每12 h 1次,连用5 d。检测4组患者治疗前后心肌肌钙蛋白I(cTnI)、磷酸肌酸激酶同工酶(CK-MB)、B型钠尿肽(BNP)、降钙素原(PCT)、C反应蛋白(CRP)水平,并进行APACHEⅡ评分,统计ICU住院时间。结果治疗后4组cTnI、BNP、PCT、CRP水平及APACHEⅡ评分均明显降低(P均<0.05),且联合组cTnI、BNP、PCT、CRP水平均明显低于其他3组(P均<0.05),乌司他丁组、血必净组均明显低于对照组(P均<0.05);血必净组PCT、CRP水平均明显低于乌司他丁组(P均<0.05);联合组APACHEⅡ评分明显低于对照组(P<0.05),但与血必净组、乌司他丁组比较差异均无统计学意义(P均>0.05)。联合组ICU住院时间明显短于其他3组(P均<0.05),血必净组、乌司他丁组均明显短于对照组(P均<0.05),但乌司他丁组与血必净组比较差异无统计学意义(P>0.05)。结论血必净联合乌司他丁治疗脓毒症心肌损伤存在协同治疗效果,可增强损伤心肌的保护效应,缩短ICU住院时间,改善预后。Objective It is to investigate the effects of Xuebijing combined with ulinastatin in patients with septic myocardial injury and its possible mechanism.Methods Eighty-three patients with septic myocardial injury were randomly divided into control group（18 cases）,ulinastatin group（20 cases）,Xuebijing group（20 cases） and combination group（25 cases）.All the patients were treated according to the therapy guideline of sepsis.On the basis of routine treatment,the patients were treated with ulinastatin（400 000 IU intravenous injection,every 12 h 1 time,for 5 days） in the ulinastatin group,with Xuebijing injection（100 mL intravenously,every 12 h 1 times,for 5 days） in Xuebijing group,and with both Xuebijing injection and ulinastatin in combination group.The levels of cardiac troponin I（cTnI）,creatine kinase isoenzymes（CK-MB）,B type natriuretic peptide（BNP）,procalcitonin（PCT） and C reactive protein（CRP） were measured before and after treatment in the 4 groups,and the APACHE Ⅱ score was carried out,the time of hospitalization in ICU was counted.Results After treatment,the levels of cTnI,BNP,PCT,CRP and APACHE Ⅱ in the 4 groups were significantly decreased（all P〈0.05）.The levels of cTnI,BNP,PCT and CRP in the combination group were significantly lower than those in the other 3 groups（all P〈0.05）,the ulinastatin group and Xuebijing group were significantly lower than those of the control group（all P〈0.05）;the levels of PCT and CRP in Xuebijing group were significantly lower than those in ulinastatin group（all P〈0.05）;the APACHE Ⅱ score in the combination group was significantly lower than that in the control group（P〈0.05）,but there was no significant difference between Xuebijing group and ulinastatin group（P〈0.05）.The time of hospitalization in ICU of the combination group was significantly shorter than that of the other 3 groups（P〈0.05）,and Xuebijing group and ulinastatin group were significantly shorter than that of the control group

关 键 词：脓毒症 心肌损伤 血必净 乌司他丁 

分 类 号：R542.2[医药卫生—心血管疾病]