参附注射液联合氢化可的松对重症肺炎患者CD62E、vWF水平及心功能的影响  

Effect of Shenfu injections combined with hydrocortisone on CD62E,vWF and cardiac function in patients with severe pneumonia

作　　者：莘翼翔 刘恒 于祯 杨亚楠 云佩佩 丰永娟 左江平 SHEN Yixiang;LIU Heng;YU Zhen(hangjiakou First Hospital,Hebei,Zhangjiakou 075000,China;不详)

机构地区：[1]河北省张家口市第一医院,075000 [2]河北省张家口市肺科医院 [3]河北省张家口市第五医院 [4]河北省石家庄市第三医院 [5]河北省临城县第一医院

出　　处：《河北医药》2023年第10期1515-1518,共4页Hebei Medical Journal

基　　金：石家庄市科技局2023年指导计划(编号:2221116D)。

摘　　要：目的研究参附注射液联合氢化可的松治疗重症肺炎对患者血管内皮细胞功能、心功能及临床转归影响。方法研究选取2017年1月至2019年12月94例重症肺炎患者,采用住院顺序奇偶数法分成治疗组与对照组,每组47例,2组均给予基础抗感染、氧疗及对症支持治疗,对照组在基础治疗之上给予氢化可的松治疗,治疗组在对照组之上,给予参附注射液治疗,连续治疗7 d,比较2组血管内皮细胞功能指标[E选择素(CD62E)、血管性血友病因子(vWF)]、心肌损伤标志物[肌酸激酶(CK)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CKMB)]及心功能指标[左心室射血分数(LVEF)、每搏输出量(SV)、心输出量(CO)、心脏排血指数(CI)]及临床转归。结果治疗后3、7 d,2组CD62E、vWF、CK、LDH及CKMB均呈下降趋势,且治疗组上述指标均显著低于对照组同时间点(P<0.05);治疗后7 d,治疗组LVEF、SV、CO及CI水平均优于治疗前(P<0.05),对照组SV、CO及CI水平均优于治疗前(P<0.05),且治疗组LVEF及SV水平优于对照组(P<0.05),治疗组好转率高于对照组(P<0.05)。结论参附注射液联合氢化可的松用于重症肺炎治疗,可减轻患者血管内皮细胞功能障碍及心肌损伤,改善心功能,促进患者临床转归。Objective To observe the effect of Shenfu injections combined with hydrocortisone on vascular endothelial cell function,cardiac function and clinical outcomes of patients with severe pneumonia.Methods A total of 94 patients with severe pneumonia from January 2017 to December 2019 were selected and allocated to treatment group and control group by the odd even method of hospitalization order,with 47 cases in each group.Basic anti-infection,oxygen therapy,symptomatic support treatment and hydrocortisone were given in both groups,and treatment group was additionally given Shenfu injections.A 7-day treatment was performed,the aim was to compare vascular endothelial cell function indexes including E-selectin(CD62E),von Willebrand factor(vWF),myocardial injury markers including creatine kinase(CK),lactate dehydrogenase(LDH),creatine kinase isoenzyme(CKMB),and cardiac function indicators including left ventricular ejection fraction(LVEF),stroke volume(SV),cardiac output(CO),cardiac output index(CI),as well as clinical outcomes.Results At 3d and 7d after treatment,the vascular endothelial cell function indexes(CD62E,vWF)and myocardial injury markers(CK,LDH and CKMB)in both groups showed a downward trend,which were significantly lower in treatment group than in control group at the same time point(P<0.05).At 7d after treatment,the levels of LVEF,SV,CO and CI in treatment group were significantly better than those before treatment(P<0.05),and the levels of SV,CO and CI in control group were better than those before treatment(P<0.05).The levels of LVEF and SV in treatment group were significantly better than those in control group(P<0.05).The improvement rate of treatment group was significantly higher than that in control group(P<0.05).Conclusion Shenfu injections combined with hydrocortisone for severe pneumonia can alleviate vascular endothelial cell dysfunction and myocardial injury,improve cardiac function,and promote clinical outcomes.

关 键 词：重症肺炎 氢化可的松 糖皮质激素 心功能 可溶性E选择素 血友病因子 

分 类 号：R563.1[医药卫生—呼吸系统]