严重脓毒症心肌损伤患者应用舒血宁治疗前后早期心肌损伤指标及氧化应激水平的变化

发布时间：2018-03-14 12:01

  本文选题：脓毒症　切入点：心肌损伤　出处：《第二军医大学学报》2017年06期 　论文类型：期刊论文

【摘要】：目的探讨舒血宁对严重脓毒症心肌损伤患者早期心肌损伤指标和氧化应激水平的影响。方法选择我院2013年3月至2016年6月收治的符合严重脓毒症伴心肌损伤患者102例,随机分为对照组和治疗组,各51例,对照组给予常规治疗;治疗组在常规治疗基础上加用舒血宁。记录两组患者在治疗前(入院时)及治疗后(入院后)6h、72hN-末端脑钠钛前体(NT-proBNP)、心型脂肪酸结合蛋白(hFABP)、肌钙蛋白I(cTnI)、丙二醛(MDA)、超氧化物歧化酶(SOD)及谷胱甘肽过氧化物酶(GSH-Px)等各指标的变化,同时观察患者左室射血分数(LVEF)水平、急性生理学和慢性健康状况评分Ⅱ(APACHEⅡ)的变化,以及ICU住院时间和28d生存情况。结果治疗前两组患者NTproBNP、hFABP、cTnI、MDA、SOD、GSH-Px各指标及APACHEⅡ评分、LVEF比较,差异无统计学意义(P0.05)。治疗后6h,治疗组患者NT-proBNP、hFABP、cTnI和MDA水平均低于对照组,SOD和GSH-Px活性均高于对照组,差异均有统计学意义(P0.05);两组患者NT-proBNP、hFABP、cTnI和MDA水平均较组内治疗前升高,SOD和GSH-Px活性均较组内治疗前降低(P0.05)。治疗后72h,两组hFABP和MDA水平均较治疗后6h降低,NTproBNP、cTnI水平,SOD、GSH-Px活性均较治疗后6h升高,差异有统计学意义(P0.05)。治疗后72h,对照组NTproBNP、cTnI和MDA水平均高于治疗组,SOD和GSH-Px活性均低于治疗组,差异有统计学意义(P0.05),两组患者hFABP水平比较差异无统计学意义(P0.05)。两组患者治疗后APACHEⅡ评分均较治疗前改善(P0.05),而两组治疗后的LVEF和ICU住院时间差异无统计学意义(P0.05);治疗组患者28d病死率低于对照组,差异有统计学意义(P0.05)。结论舒血宁对严重脓毒症心肌损伤患者的疗效优于常规治疗,能降低NT-proBNP、hFABP、cTnI、MDA水平和APACHEⅡ评分,提高SOD和GSH-Px活性,改善患者预后。
[Abstract]:Objective to investigate the effects of Shuxuening on early myocardial injury index and oxidative stress in patients with severe sepsis. Methods 102 patients with severe sepsis with myocardial injury were selected from March 2013 to June 2016 in our hospital. They were randomly divided into control group and treatment group with 51 cases each. The control group was given routine treatment. The patients in the treatment group were treated with Shuxuening on the basis of routine treatment. Before and after treatment, NT-proBNPP, cardiac fatty acid binding protein, cardiac fatty acid binding protein, malondialdehyde (MDA), malondialdehyde (MDA) MDAA, NT-proBNPP, cardiac fatty acid binding protein, malondialdehyde (malondialdehyde) MDAA were recorded before and after treatment in both groups. The changes of chemical dismutase (SOD) and glutathione peroxidase (GSH-Px), At the same time, the changes of left ventricular ejection fraction (LVEFX), acute physiology and chronic health status 鈪，

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