中西医联合用药方案强化脓毒症心肌损伤保护的效果研究

发布时间：2018-04-28 06:37

本文选题：脓毒症 + 心肌损伤　；参考：《重庆医学》2017年15期

【摘要】：目的观察乌司他丁联合加味参附颗粒对脓毒症心肌损伤的保护作用。方法入选的98例脓毒症伴心肌损伤患者均接受脓毒症集束化治疗,对照组加用乌司他丁,观察组在对照组基础上再加用加味参附颗粒。结果与治疗前比较,治疗后两组患者的4项心肌损伤标记物指标[肌钙蛋白I(cTnI)、B型脑钠肽(BNP)、乳酸脱氢酶(LD)、肌酸激酶同工酶(CK-MB)]水平均明显降低(P0.01),其中观察组降低程度更大,治疗后组间比较差异均有统计学意义(P0.01);治疗后两组患者的血流动力学指标中,心脏指数(CI)、每搏量指数(SVI)、全心舒张期末容积指数(GEDVI)均明显升高(P0.01),HR均明显降低(P0.01),且观察组各指标水平改变程度较对照组明显更大,治疗后组间比较差异均有统计学意义(P0.01);治疗后两组患者的肿瘤坏死因子α(TNF-α)、超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)水平均明显降低(P0.01),其中观察组降低程度更大,治疗后组间比较差异均有统计学意义(P0.01);两组患者的急性生理与慢性健康状况评分系统(APACHEⅡ)评分均较治疗前明显降低(P0.01),观察组多器官功能障碍综合征MODS发生率较治疗前明显降低(P0.05)。结论乌司他丁联合加味参附颗粒对脓毒症心肌损伤具有协同保护作用。
[Abstract]:Objective to observe the protective effect of ulinastatin combined with modified Shenfu granule on myocardial injury of sepsis. Methods 98 patients with sepsis accompanied with myocardial injury were treated with sepsis cluster therapy, the control group was treated with ulinastatin, and the observation group was treated with Jiawei Shenfu granule on the basis of the control group. Results compared with those before treatment, the levels of four myocardial injury markers (BNPN, LDD, CK-MBB) of the two groups were significantly lower than those before treatment, especially in the observation group. There were significant differences between the two groups after treatment (P 0.01). Cardiac index, SVI, GEDVI) were significantly increased, and P0.01T / HR was significantly decreased in the observation group than in the control group, and the change degree of each index in the observation group was significantly greater than that in the control group. After treatment, the levels of TNF- 伪 TNF- 伪, hypersensitive C-reactive protein hs-CRPU, interleukin-6 (IL-6) were significantly decreased in the two groups, especially in the observation group, and the difference between the two groups after treatment was statistically significant (P 0.01), and the levels of TNF- 伪, hs-CRPU and IL-6 in the treatment group were significantly lower than those in the control group, especially in the observation group. The scores of acute physiological and chronic health status of the two groups were significantly lower than those before treatment, and the incidence of multiple organ dysfunction syndrome (MODS) in the observation group was higher than that in the control group. Before treatment, P 0.05 was significantly decreased. Conclusion Ulinastatin combined with modified Shenfu granule has synergistic protective effect on septic myocardial injury.
【作者单位】：广州中医药大学附属广东省第二中医院重症医学科;
【分类号】：R459.7;R542.2

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