环磷腺苷葡胺联合地高辛治疗脓毒症致心肌顿抑性心力衰竭的疗效分析

发布时间：2018-01-14 15:03

本文关键词：环磷腺苷葡胺联合地高辛治疗脓毒症致心肌顿抑性心力衰竭的疗效分析　出处：《中国全科医学》2017年17期 　论文类型：期刊论文

【摘要】：目的探讨环磷腺苷葡胺联合地高辛治疗脓毒症致心肌顿抑性心力衰竭的疗效。方法选取2013年1月—2015年6月安徽医科大学附属宿州医院急诊科和全科医学科收治的脓毒症致心肌顿抑性心力衰竭患者58例,采用随机数字表法分为治疗组29例和对照组29例,两组均予常规对症治疗,治疗组在常规治疗基础上加用5%葡萄糖注射液250 ml+环磷腺苷葡胺180 mg+胰岛素4 U,静脉滴注;地高辛0.125 mg,口服,1次/d。对照组加用地高辛0.125mg,口服,1次/d。两组患者分别于治疗前、治疗后第7天抽静脉血和/或动脉血查心肌肌钙蛋白I(c Tn-I)、脑钠肽(BNP)、C反应蛋白(CRP)、血乳酸(Lac)、降钙素原(PCT),并进行急性生理与慢性健康状况评分系统Ⅱ(APACHEⅡ评分)及床旁彩超检测左心室射血分数(LVEF)。结果两组患者治疗前c Tn-I、BNP、CRP、Lac、PCT水平、APACHEⅡ评分、LVEF比较,差异均无统计学意义(P0.05);治疗后治疗组c Tn-I、BNP、CRP、Lac、PCT水平、APACHEⅡ评分低于对照组,LVEF高于对照组(P0.05)。两组不良反应发生率比较,差异无统计学意义[44.8%(13/29)与51.7%(15/29),χ~2=0.276,P=0.599];两组2周后病死率比较,差异有统计学意义[34.5%(10/29)与10.3%(3/29),χ~2=4.858,P=0.028]。结论环磷腺苷葡胺联合地高辛治疗脓毒症致心肌顿抑性心力衰竭,可明显减轻心肌损伤及全身炎性反应,改善心功能,降低病死率。
[Abstract]:Objective to investigate the therapeutic effect of McAMP combined with digoxin in the treatment of sepsis induced myocardial stunning in congestive heart failure. Methods the emergency department of Suzhou Hospital Affiliated to Medical University Of Anhui from January 2013 to June 2015 and the Department of family medicine from sepsis induced myocardial stunning of heart failure in patients with 58 cases, were randomly divided into treatment group of 29 cases and the control group of 29 cases, two groups were given conventional symptomatic treatment, the treatment group was treated with 5% Glucose Injection ml+ 250 on the basis of routine treatment of meglumine adenosine cyclophosphate 180 mg+ insulin 4 U, intravenous injection; digoxin 0.125 mg orally, 1 times /d., the control group was treated with digoxin orally, 1 0.125mg, two /d. groups of patients respectively before treatment, after treatment seventh days. Venous blood and / or arterial blood check of cardiac troponin I (C Tn-I), brain natriuretic peptide (BNP), C reactive protein (CRP), blood lactate (Lac), procalcitonin (PCT), and acute physiology and chronic Sexual health evaluation II (APACHE II) and bedside ultrasound detection of left ventricular ejection fraction (LVEF). The results of two groups of patients before treatment, C Tn-I, BNP, CRP, Lac, PCT level, APACHE score, LVEF, showed no significant difference (P0.05); the treatment group after treatment C Tn-I, BNP, CRP, Lac, PCT level, APACHE score lower than the control group, LVEF was higher than the control group (P0.05). The adverse effects of the two groups, there was no significant difference between [44.8% (13/29) and 51.7% (15/29), X ~2=0.276, P=0.599]; the two group after 2 week mortality rate comparison, difference there was statistical significance in [34.5% (10/29) and 10.3% (3/29), X ~2=4.858, P=0.028]. conclusion McAMP combined with digoxin in the treatment of sepsis induced myocardial stunning of heart failure, can significantly reduce myocardial injury and systemic inflammatory response, improve heart function, reduce the mortality rate.

【作者单位】：安徽医科大学附属宿州医院
【分类号】：R459.7;R541.6
【正文快照】： 脓毒症是急诊重症患者的常见疾病,严重的脓毒症患者容1.3.1治疗方法两组均予抗感染、止咳化痰、降压、降糖、易并发不同程度的心肌顿抑,发生率约为50%,其中7%的患纠正水电酸碱平衡紊乱、预防并发症、加强营养支持等对症治者发生心力衰竭,并且一旦并发心肌损伤,病死率将显著升

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