左西孟旦与多巴酚丁胺对脓毒症休克患者心肌抑制影响的对比观察

发布时间：2018-11-08 07:52

【摘要】：目的:探讨脓毒症休克患者分别应用左西孟旦(LEV)与多巴酚丁胺(Dob)对心肌抑制的改善效果。方法:选取我院2014年7月~2016年6月收治的63例脓毒症休克患者,依照随机数字表法分为观察组(31例)和对照组(32例)。两组均给予常规基础治疗,在其基础上,对照组予以Dob治疗,观察组给予LEV治疗。记录比较两组治疗前后左室收缩期末容积指数(LVESI)、左室舒张期末容积指数(LVEDI)及左心射血分数(LVEF)、心肌肌钙蛋白I(cTnI)、脑钠肽(BNP)及急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分,预后情况。结果:与治疗前比较,两组治疗7 d时LVESI、LVEDI、LVEF,均显著改善(P0.01);且观察组改善程度较对照组相比,更为显著(P0.01);两组治疗7d时血清cTnI、BNP水平和APACHEⅡ评分,均显著低于治疗前(P0.01);与对照组治疗7d时相比,观察组心肌损伤指标及APACHEⅡ评分改善程度均更为显著(P0.01);观察组28d生存率为54.8%略高于对照组的50.0%,但组间差异无统计学意义(P0.05)。结论:脓毒症休克患者应用LEV更有利于提高心脏功能,稳定病情,改善心肌抑制,具有较高临床推广价值。
[Abstract]:Aim: to investigate the effects of levsimendan (LEV) and dobutamine (Dob) on myocardial inhibition in septic shock patients. Methods: 63 patients with septic shock from July 2014 to June 2016 were randomly divided into observation group (n = 31) and control group (n = 32). On the basis of routine basic therapy, the control group was treated with Dob and the observation group with LEV. Left ventricular end-systolic volume index (LVESI),) and left ventricular end-diastolic volume index (LVEDI) and left ventricular ejection fraction (LVEF),) cardiac troponin I (cTnI), were recorded and compared between the two groups before and after treatment. Brain natriuretic peptide (BNP), acute physiology and chronic health status scoring system 鈪，

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