特利加压素联合去甲肾上腺素对脓毒症休克患者心肺损伤指标及微循环的影响  

Effect of Terlipressin Combined with Norepinephrine on Cardiopulmonary Injury Indexes and Microcirculation in Patients with Septic Shock

作　　者：廖泽美 涂学平 马超 LIAO Zemei;TU Xueping;MA Chao(Enshi Central Hospital,Hubei Province,Enshi 445000,China;不详)

机构地区：[1]湖北省恩施市中心医院,湖北恩施445000

出　　处：《中国医学创新》2023年第20期5-10,共6页Medical Innovation of China

基　　金：湖北省卫生健康委员会科研面上项目(WJ2019M101)。

摘　　要：目的:探究特利加压素联合去甲肾上腺素对脓毒症休克患者心肺损伤指标及微循环的影响。方法:选取2019年1月—2023年1月于恩施市中心医院重症医学科治疗的脓毒症休克患者80例,应用随机数字表法将其分为对照组及观察组,对照组(n=40)采用去甲肾上腺素治疗,观察组(n=40)采用去甲肾上腺素联合特利加压素治疗。对比两组炎症因子[降钙素原(PCT)、白细胞介素-6(IL-6)、C反应蛋白(CRP)],心肺损伤指标[肌酸激酶同工酶(CK-MB)、氧合指数(OI)、心肌肌钙蛋白(cTnI)、乳酸脱氢酶(LDH)、脑钠肽(BNP)],序贯器官衰竭估计(sequential organ failure assessment,SOFA)评分、急性生理与慢性健康评分(acute physiology and chronic health evaluationⅡ,APACHEⅡ),肝素结合蛋白(HBP),微循环指标[氧输送(DO_(2))、氧耗(VO_(2))、中心静脉氧饱和度(SvO_(2))],肠道功能指标[D-乳酸(D-Lac)、二胺氧化酶(DAO)、肠型脂肪酸结合蛋白(I-FABP)]。结果:治疗前,两组PCT、IL-6、CRP水平比较,差异均无统计学意义(P>0.05);治疗后,两组PCT、IL-6、CRP水平均较治疗前降低,且观察组均低于对照组(P<0.05)。治疗前,两组CK-MB、OI、cTnI、LDH、BNP水平比较,差异均无统计学意义(P>0.05);治疗后,两组OI水平均较治疗前升高、CK-MB、cTnI、LDH、BNP水平均较治疗前降低,观察组OI水平高于对照组,CK-MB、cTnI、LDH、BNP水平均低于对照组(P<0.05)。治疗前,两组SOFA评分、APACHEⅡ评分、HBP水平比较,差异均无统计学意义(P>0.05);治疗后,两组SOFA评分、APACHEⅡ评分、HBP水平均较治疗前降低,且观察组均低于对照组(P<0.05)。治疗前,两组DO_(2)、VO_(2)、Sv O_(2)水平比较,差异均无统计学意义(P>0.05);治疗12、24、36 h后两组DO_(2)、VO_(2)、SvO_(2)水平均较治疗前升高,且观察组均高于对照组(P<0.05)。治疗前,两组D-Lac、DAO、I-FABP水平比较,差异均无统计学意义(P>0.05);治疗12、24、36 h后两组D-Lac、DAO、I-Objective:To investigate the effects of Teripressin combined with Norepinephrine on cardiopulmonary injury indexes and microcirculation in patients with septic shock.Method:A total of 80 patients with septic shock treated in the Intensive Care Department of Enshi Central Hospital from January 2019 to January 2023 were selected and divided into control group and observation group by random number table method.The control group(n=40)was treated with Norepinephrine,and the observation group(n=40)was treated with Norepinephrine combined with Trepressin.Inflammatory factors[procalcitonin(PCT),interleukin-6(IL-6),C reactive protein(CRP)],cardiopulmonary injury indexes[creatine kinase isoenzyme(CK-MB),oxygenation index(OI),cardiac troponin(cTnI),lactate dehydrogenase(LDH),brain natriuretic peptide(BNP)],sequential organ failure assessment(SOFA)score,acute physiology and chronic health evaluationⅡ(APACHEⅡ),heparin binding protein(HBP),microcirculation indexes[oxygen delivery(DO_(2)),oxygen consumption(VO_(2)),central venous oxygen saturation(SvO_(2))],intestinal function indexes[D-lactic acid(D-Lac),diamine oxidase(DAO),enteric fatty acid binding protein(I-FABP)]were compared between the two groups.Result:Before treatment,there were no significant differences in PCT,IL-6 and CRP levels between the two groups(P>0.05).After treatment,the levels of PCT,IL-6 and CRP in both groups were lower than those before treatment,and the observation group were lower than those of the control group(P<0.05).Before treatment,there were no significant differences in CKMB,OI,cTnI,LDH and BNP levels between the two groups(P>0.05).After treatment,OI levels in both groups were higher than those before treatment,while CK-MB,cTnI,LDH and BNP levels were lower than those before treatment,OI levels in observation group was higher than that of control group,while CK-MB,cTnI,LDH and BNP levels were lower than those of control group(P<0.05).Before treatment,there were no significant differences in SOFA scores,APACHEⅡscores and HBP levels betwee

关 键 词：特利加压素 去甲肾上腺素 脓毒症休克 心肺损伤指标 微循环指标 

分 类 号：R459.7[医药卫生—急诊医学]