参麦注射液在脓毒症心肌损伤患者中的作用  

Effect of Shenmai injection on sepsis patients with myocardial injury

作　　者：何聪[1] 龙玲[1] 杜全胜[1] 冯静 刘春霞[1] 王显雷[3] HE Cong;LONG Ling;DU Quan-sheng;FENG Jing;LIU Chun-xia;WANG Xian-lei(Department of ICU,Hebei General Hospital,Shijiazhuang 050051,China;Department ofRespiratory Medicine,Pingshan County Hospital,Hebei Province,Pingshan 050400,China;Tuberculosis Three Districts,Hebei Chest Hospital,Shijiazhuang 050041,China)

机构地区：[1]河北省人民医院重症医学科,河北石家庄050051 [2]河北省平山县医院呼吸科,河北平山050400 [3]河北省胸科医院结核三病区,河北石家庄050041

出　　处：《河北医科大学学报》2019年第7期785-788,共4页Journal of Hebei Medical University

基　　金：河北省中医药管理局科技计划项目(2015144)

摘　　要：目的探讨参麦注射液对脓毒症心肌损伤患者的心脏保护作用。方法选择诊断为脓毒症心肌损伤的患者32例,均行有创性血流动力学监测及超声监测,指导液体复苏,均给予规范的常规集束化治疗(抗感染、呼吸及循环支持等)。随机将32例患者分为2组各16例。对照组采用规范的集束化治疗;治疗组采用规范的集束化治疗+参麦注射液200 mL,每日1次,连续7 d。结果 2组第1天、第4天间脑钠素(brain natriuretic peptide,BNP)和肌钙蛋白I(troponin I,cTnI)水平差异均无统计学意义( P > 0.05),治疗组第7天BNP和cTnI水平高于对照组,差异有统计学意义( P < 0.05);随时间延长,2组肌酸激酶同工酶(creatine kinase isoenzyme MB,CK-MB)水平均有下降,但2组第1天、第4天和第7天CK-MB水平差异均无统计学意义( P > 0.05)。2组心电图好转率差异无统计学意义( P > 0.05)。2组住ICU时间、28 d病死率差异均无统计学意义( P > 0.05)。结论参麦注射液对脓毒症心肌损伤患者心肌可起到一定的保护作用。Objective To investigate the cardioprotective effect of Shenmai injection in patients with sepsis and myocardial injury. Methods Thirty-two patients with myocardial injury due to sepsis were selected.All patients underwent invasive hemodynamic monitoring and ultrasound monitoring to guide fluid resuscitation.All patients were given standard conventional bundle therapy(anti-infection,respiratory and circulatory support,etc.).32 patients were randomly divided into 2 groups,16 cases per group.The control group: standard bundle treatment.Treatment group: standardized bundle therapy + Shenmai injection 200 mL,once daily for 7 days. Results There was no significant difference in brain natriuretic peptide(BNP) level and troponin I(cTnI) level between two groups on day 1 and day 4( P > 0.05).The level of BNP and cTnI in the treatment group on day 7 was higher than that in the control group,and the difference was statistically significant( P < 0.05).The creatine kinase isoenzyme MB(CK-MB) level in both groups decreased with time,but the level of CK-MB in the two groups on day 1,4 and 7 decreased.There was no statistically significant difference in the improvement rate of ECG between two groups( P > 0.05).There was no statistically significant difference in the length of ICU stay and 28-day mortality between two groups( P > 0.05). Conclusion Shenmai injection can protect the myocardium of patients with sepsis myocardial injury.

关 键 词：脓毒症 心肌损伤 参麦注射液 

分 类 号：R631[医药卫生—外科学] R542.2[医药卫生—临床医学]