左西孟旦与乌司他丁联用对脓毒症休克肝素结合蛋白水平的影响  

Effect of Levosimendan Combined with Ulinastatin on the Level of Heparin-binding Protein in Septic Shock

作　　者：沈杰 孙晋华 许东平 杨智凯 黄明 高国晋 黄景泰 SHEN Jie;SUN Jinhua;XU Dongping;YANG Zhikai;HUANG Ming;GAO Guojin;HUANG Jingtai(Xiamen Changgeng Hospital,Fujiang Xiamen 361028;Taiwan Linkou Medical Center,Taiwan New Taipei 24441,China)

机构地区：[1]厦门长庚医院,福建厦门361028 [2]台湾林口医学中心,中国台湾新北24441

出　　处：《深圳中西医结合杂志》2024年第20期5-8,共4页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

基　　金：厦门市科学技术局医疗卫生指导性项目(3502Z20214ZD1113);厦门长庚医院科研项目(CMRPG1E0873)。

摘　　要：目的:分析无创血流动力学阻抗心动描记法(ICG)监测下左西孟旦(LEVO)与乌司他丁(UTI)联用对脓毒症休克(SS)肝素结合蛋白(HBP)水平的影响。方法:收集厦门长庚医院2021年10月至2024年4月重症监护室(ICU)40例SS患者临床资料进行分析,根据不同治疗方案分为观察组和对照组,各20例。对照组接受ICG监测下LEVO治疗,观察组接受ICG下LEVO与UTI联合治疗,比较两组患者疗效;比较治疗前、治疗3 d后血流动力学[心输出量(CO)、心脏指数(CI)、外周血管阻力(SVR)、外周血管阻力指数(SVRI)、每搏变异度(SVV)]、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分及治疗前、治疗3 d后、治疗7 d后HBP水平。结果:两组患者治疗3 d后总有效率比较,差异无统计学意义(P>0.05);治疗3 d后,观察组APACHEⅡ评分、CO、CI、SVV水平较对照组低,SVR、SVRI较对照组高,差异具有统计学意义(P<0.05);观察组治疗3 d后、治疗7 d后HBP水平较对照组低,差异具有统计学意义(P<0.05)。结论:ICG下LEVO与UTI联用治疗SS的效果确切,能有效改善患者病情程度,调节血流动力学水平,降低HBP水平。Objective To analyze the effects of levosimendan(LEVO)combined with ulinastatin(UTI)on the level of heparinbinding protein(HBP)in septic shock(SS)under non-invasive hemodynamic impedance cardiography(ICG)monitoring.Method Clinical data of 40 SS patients in the intensive care unit(ICU)of Xiamen Changgeng Hospital from October 2021 to April 2024 were collected and analyzed.According to different treatment regimens,they were divided into an observation group and a control group,with 20 cases in each group.The control group received LEVO treatment under ICG monitoring,and the observation group received LEVO and UTI combined treatment under ICG.The efficacy of the two groups was compared.The hemodynamics[cardiac output(CO),cardiac index(CI),systemic vascular resistance(SVR),systemic vascular resistance index(SVRI),stroke volume variation(SVV)],acute physiology and chronic health evaluationⅡ(APACHEⅡ)score before treatment and 3 days after treatment were compared.And HBP levels were compared before treatment,3 days after treatment and 7 days after treatment.Result There was no significant difference in the total effective rate between the two groups after 3 days of treatment(P>0.05).After 3 days of treatment,the APACHEⅡscore,the levels of CO,CI and SVV in the observation group were lower than those in the control group,and SVR and SVRI were higher than those in the control group,with statistical significances(P<0.05).The level of HBP of the observation group was lower than that of the control group after 3 and 7 days of treatment,and the difference was statistically significant(P<0.05).Conclusion The combination of LEVO and UTI under ICG is effective in the treatment of SS,which can effectively improve the severity of patients'disease,regulate the hemodynamic level and reduce the level of HBP.

关 键 词：脓毒症休克 无创血流动力学 左西孟旦 乌司他丁 肝素结合蛋白 

分 类 号：R631.4[医药卫生—外科学]