右美托咪定对早期脓毒症患者心脏舒张功能的改善作用

发布时间：2018-06-16 22:06

本文选题：右美托咪定 + 脓毒症　；参考：《中国老年学杂志》2017年10期

【摘要】：目的探讨右美托咪定治疗早期脓毒症患者心肌损伤的疗效。方法脓毒症患者67例采用随机数字法分为观察组(35例)和对照组(32例),观察组在常规治疗基础上给予右美托咪定镇静治疗,对照组在常规治疗基础上给予相同剂量生理盐水,观察并比较治疗前后两组心功能情况、炎症指标及心肌酶谱水平。结果治疗后观察组心率(HR)、血压水平均显著降低,舒张早期二尖瓣流入速度/心房舒张期二尖彟流入速度(E/A)水平显著升高且改善情况较对照组更明显(均P0.05);治疗后观察组肿瘤坏死因子(TNF)-α、白细胞介素(IL)-1及IL-6水平均显著降低(P0.05),对照组各炎症指标水平均无显著变化(P0.05),且观察组各项指标水平均低于对照组(P0.05);两组治疗前后肌酸激酶同工酶(CKMb)、肌红蛋白(MYO)及传统肌钙蛋白(c Tn)I水平比较差异均无统计学意义(P0.05)。结论右美托咪定对早期脓毒症患者心脏收缩功能影响较小,可改善心肌的舒张功能,降低炎性因子释放,对早期脓毒症患者心肌损伤具有保护作用。
[Abstract]:Objective to investigate the effect of dexmetomidine on myocardial injury in patients with early sepsis. Methods 67 patients with sepsis were randomly divided into two groups: the observation group (n = 35) and the control group (n = 32). The observation group was treated with dexmetomidine on the basis of routine treatment, while the control group was given the same dose of normal saline on the basis of routine treatment. The cardiac function, inflammation index and myocardial enzyme spectrum were observed and compared before and after treatment. Results after treatment, the heart rate and blood pressure in the observation group were significantly lower than those in the control group. The early diastolic mitral inflow velocity / atrial diastolic inflow velocity and E / A were significantly increased and the improvement was more obvious than that in the control group (all P 0.05); the levels of tumor necrosis factor TNF- 伪, interleukin-til 1 and IL-6 in the observation group after treatment were all significantly higher than those in the control group (P < 0.05). There was no significant change in each inflammatory index in the control group, and the level of each index in the observation group was lower than that in the control group, and the levels of creatine kinase isozyme, myoglobin MYO) and the traditional troponin C TnTnI were lower than those in the control group before and after treatment. There was no significant difference between the two groups (P 0.05). Conclusion dexmetomidine has little effect on cardiac contractile function in patients with early sepsis. It can improve the diastolic function of myocardium and reduce the release of inflammatory factors. It has protective effect on myocardial injury in patients with early sepsis.
【作者单位】：晋江市医院重症医学科;
【分类号】：R459.7

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