發(fā)布時間：2018-04-28 06:37

  本文選題：膿毒癥 + 心肌損傷��； 參考：《重慶醫(yī)學(xué)》2017年15期

【摘要】：目的觀察烏司他丁聯(lián)合加味參附顆粒對膿毒癥心肌損傷的保護(hù)作用。方法入選的98例膿毒癥伴心肌損傷患者均接受膿毒癥集束化治療,對照組加用烏司他丁,觀察組在對照組基礎(chǔ)上再加用加味參附顆粒。結(jié)果與治療前比較,治療后兩組患者的4項心肌損傷標(biāo)記物指標(biāo)[肌鈣蛋白I(cTnI)、B型腦鈉肽(BNP)、乳酸脫氫酶(LD)、肌酸激酶同工酶(CK-MB)]水平均明顯降低(P0.01),其中觀察組降低程度更大,治療后組間比較差異均有統(tǒng)計學(xué)意義(P0.01);治療后兩組患者的血流動力學(xué)指標(biāo)中,心臟指數(shù)(CI)、每搏量指數(shù)(SVI)、全心舒張期末容積指數(shù)(GEDVI)均明顯升高(P0.01),HR均明顯降低(P0.01),且觀察組各指標(biāo)水平改變程度較對照組明顯更大,治療后組間比較差異均有統(tǒng)計學(xué)意義(P0.01);治療后兩組患者的腫瘤壞死因子α(TNF-α)、超敏C反應(yīng)蛋白(hs-CRP)、白細(xì)胞介素6(IL-6)水平均明顯降低(P0.01),其中觀察組降低程度更大,治療后組間比較差異均有統(tǒng)計學(xué)意義(P0.01);兩組患者的急性生理與慢性健康狀況評分系統(tǒng)(APACHEⅡ)評分均較治療前明顯降低(P0.01),觀察組多器官功能障礙綜合征MODS發(fā)生率較治療前明顯降低(P0.05)。結(jié)論烏司他丁聯(lián)合加味參附顆粒對膿毒癥心肌損傷具有協(xié)同保護(hù)作用。
[Abstract]:Objective to observe the protective effect of ulinastatin combined with modified Shenfu granule on myocardial injury of sepsis. Methods 98 patients with sepsis accompanied with myocardial injury were treated with sepsis cluster therapy, the control group was treated with ulinastatin, and the observation group was treated with Jiawei Shenfu granule on the basis of the control group. Results compared with those before treatment, the levels of four myocardial injury markers (BNPN, LDD, CK-MBB) of the two groups were significantly lower than those before treatment, especially in the observation group. There were significant differences between the two groups after treatment (P 0.01). Cardiac index, SVI, GEDVI) were significantly increased, and P0.01T / HR was significantly decreased in the observation group than in the control group, and the change degree of each index in the observation group was significantly greater than that in the control group. After treatment, the levels of TNF- 偽 TNF- 偽, hypersensitive C-reactive protein hs-CRPU, interleukin-6 (IL-6) were significantly decreased in the two groups, especially in the observation group, and the difference between the two groups after treatment was statistically significant (P 0.01), and the levels of TNF- 偽, hs-CRPU and IL-6 in the treatment group were significantly lower than those in the control group, especially in the observation group. The scores of acute physiological and chronic health status of the two groups were significantly lower than those before treatment, and the incidence of multiple organ dysfunction syndrome (MODS) in the observation group was higher than that in the control group. Before treatment, P 0.05 was significantly decreased. Conclusion Ulinastatin combined with modified Shenfu granule has synergistic protective effect on septic myocardial injury.
【作者單位】： 廣州中醫(yī)藥大學(xué)附屬廣東省第二中醫(yī)院重癥醫(yī)學(xué)科;
【分類號】：R459.7;R542.2

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