心型脂肪酸结合蛋白和可溶性CD14亚型在丹参川芎嗪治疗脓毒症心肌损伤中的变化

发布时间：2018-05-23 22:31

本文选题：脓毒症 + 心肌损伤　；参考：《实用医学杂志》2016年23期

【摘要】：目的:观察心型脂肪酸结合蛋白(H-FABP)和可溶性CD14亚型(Presepsin)在丹参川芎嗪治疗脓毒症心肌损伤患者中的变化及意义。方法:114例脓毒症心肌损伤患者随机分成对照组和治疗组,对照组给予常规治疗,治疗组在对照组基础上加丹参川芎嗪。患者治疗前及治疗6 h、3 d,检测H-FABP、Presepsin、肌钙蛋白I(cTnI)及N-末端脑钠肽前体(NT-proBNP)的变化,观察治疗前后LVEF、SOFA评分、主要心脏不良事件(MACE)发生率及28 d病死率。结果:治疗6 h,治疗组H-FABP、Presepsin、cTnI和NT-proBNP低于对照组(P0.05),两组H-FABP、cTnI和NT-proBNP高于治疗前,Presepsin低于治疗前(P0.05)。治疗3 d,两组cTnI和NT-proBNP较治疗6 h升高,Presepsin较治疗6 h降低(P0.05),对照组Presepsin、cTnI和NT-proBNP高于治疗组(P0.05)。治疗组治疗后SOFA评分、LVEF、累计MACE发生率和28 d病死率低于对照组(P0.05)。患者H-FABP与SOFA评分呈正相关(P0.05)。结论:丹参川芎嗪能降低患者H-FABP、Presepsin、cTnI和NT-proBNP,改善LVEF,降低28 d病死率,减少MACE发生,为指导临床治疗提供依据。
[Abstract]:Aim: to observe the changes and significance of cardiac fatty acid binding protein (H-FABP) and soluble CD14 subtype presepsin in the treatment of septic myocardial injury with Salvia miltiorrhiza Ligustrazine. Methods 114 patients with septic myocardial injury were randomly divided into control group and treatment group. The control group was treated with routine therapy, and the treatment group was treated with salvia miltiorrhiza ligustrazine on the basis of control group. The changes of H-FABPP-Presepsin, cardiac troponin I cTnI and NT-proBNPs were detected before and after treatment. The LVEFSFA scores, the incidence of major adverse cardiac events (MACEE) and the fatality rate of 28 days were observed before and after treatment. Results: at 6 h after treatment, the levels of H-FABPnI and NT-proBNP in the treatment group were lower than those in the control group (P 0.05), and the levels of H-FABPnI and NT-proBNP in the two groups were higher than those in the pre-treatment group (P 0.05). On the 3rd day of treatment, cTnI and NT-proBNP in both groups were significantly higher than those in the treatment group at 6 h. The levels of presepsin cTnI and NT-proBNP in the control group were significantly higher than those in the treatment group at 6 h after treatment, and the levels of P0.05G in the control group were higher than those in the control group. After treatment, the SOFA score, cumulative MACE incidence and fatality rate in the treatment group were lower than those in the control group (P 0.05). There was a positive correlation between H-FABP and SOFA score (P 0.05). Conclusion: Salvia miltiorrhiza tetramethylpyrazine can reduce the H-FABPP-presepsinsinsinsinsintosine cTnI and NT-proBNPs, improve LVEF, reduce the fatality rate of 28 days, reduce the incidence of MACE, and provide the basis for guiding clinical treatment.
【作者单位】：河北医科大学附属哈励逊国际和平医院急救医学部;河北医科大学附属哈励逊国际和平医院重症医学科;
【基金】：衡水市科学技术研究与发展计划项目(编号:15019)
【分类号】：R459.7;R542.2

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