血必净注射液对脓毒症心肌保护的临床研究  

Clinical research of Xuebijing injection on myocardial protection from sepsis

作　　者：廖云海 卢静[1] 王志民[1] 许钦[1] LIAO Yunhai;LU Jing;WANG Zhimin;XU Qin(Department of Emergency,the Second Affiliated Hospital of Fujian Traditional Chinese Medical University,Fujian,Fuzhou 350003,China)

机构地区：[1]福建中医药大学附属第二人民医院急诊科,福建福州350003

出　　处：《中国医药科学》2020年第22期55-57,共3页China Medicine And Pharmacy

基　　金：福建省自然科学基金(2018J01321)。

摘　　要：目的探讨血必净注射液对脓毒症患者心肌损伤的保护作用及其可能作用机制。方法采用随机数字表法将我院ICU收治确诊脓毒症合并心肌损伤的45例患者分为对照组(20例)、血必净组(25例)。比较两组治疗前后检测肌钙蛋白Ⅰ(cTnI)、N末端B脑钠肽前体(NT-proBNP)、心肌肌酸同工酶(CK-MB)水平的变化。同时采用床旁心脏彩超监测心功能,比较治疗前后左室射血分数(LVEF)、心脏指数(CI)的变化。结果两组患者治疗后cTnI、CK-MB、NT-proBNP均下降,血必净组cTnI为(0.87±0.28)μg/L、CK-MB为(12.55±3.65)U/L、NT-proBNP为(784.47±196.44)pg/mL,显著低于对照组的(1.34±0.64)μg/L、(17.73±3.52)U/L、(1165.68±304.85)pg/mL,差异有统计学意义(P<0.05)。两组治疗后床旁超声心动图示LVEF、CI均改善,血必净组LVEF为(0.55±0.05)、CI为(2.97±0.28)L/(min·m2),均高于对照组LVEF的(0.52±0.05)、CI的(2.72±0.33)L/(min·m2),差异有统计学意义(P<0.05)。结论通过对脓毒症心肌损伤患者床旁超声心动图及心肌标志物水平的观察,提示血必净注射液在心肌损伤方面具有一定的保护作用。Objective To investigate the protective function of Xuebijing injection on myocardial injury in patients with sepsis and its possible mechanism.Methods 45 patients with sepsis complicated with myocardial injury admitted to ICU of our hospital were divided into the control group(n=20)and the Xuebijing group(n=25)according to the random number table method.The level changes of cardiac troponin I(cTnI),N-terminal pro-brain natriuretic peptide(NT-proBNP)and creatine kinase isoenzymes(CK-MB)were compared between the two groups before and after treatment.At the same time,cardiac function was monitored by bedside echocardiography,and the changes of left ventricular ejection fraction(LVEF)and cardiac index(CI)were compared before and after treatment.Results The levels of cTnI,CK-MB and NT-proBNP decreased in both groups of patients after treatment.CTnI was(0.87±0.28)μg/L,CK-MB was(12.55±3.65)U/L,NT proBNP was(784.47±196.44)pg/mL in the Xuebijing group were significantly lower than CTnI was(1.34±0.64)μg/L,CK-MB was(17.73±3.52)U/L,NT proBNP was(1165.68±304.85)pg/mL in the control group,and the differences were statistically significant(P<0.05).After treatment,LVEF and CI of bedside echocardiography were improved in both groups.LVEF was(0.55±0.05),CI was(2.97±0.28)L/(min·m2)in the Xuebijing group were all higher than LVEF was(0.52±0.05),CI was(2.72±0.33)L/(min·m2)in the control group,and the differences were statistically significant(P<0.05).Conclusion By monitoring the changes of bedside echocardiography and myocardial markers of sepsis myocardial injury,it was confirmed that Xuebijing injection had a certain protective efficacy on myocardial injury.

关 键 词：脓毒症 心肌损害 血必净注射液 床旁超声心动图 

分 类 号：R631.2[医药卫生—外科学]