磷酸肌酸对脓毒症相关性心肌损伤患者心脏功能的保护作用

The protective effect of phosphocreatine oncardiac function in patients with sepsis associated myocardial injury

目的探讨磷酸肌酸对脓毒症相关性心肌损伤患者心脏功能的保护作用。方法将240例因肠穿孔合并腹腔感染导致严重脓毒症患者随机分为观察组和对照且各120例。所有患者均给予原发病手术治疗,术后入ICU监护。观察组术前及术后3d连续给予磷酸肌酸注射液静脉滴注。术后第3天分析2组患者肌酸激酶同工酶(CK-MB)、肌钙蛋白I(c Tn I)、钠尿肽(BNP)水平变化,利用心脏超声测定左心室射血分数(LVEF)、心室舒张功能:E/A、E/Ea比值。结果治疗后,观察组CK-MB、c Tn I、BNP较对照组明显减少,差异均有统计学意义(P<0.05);2组LVEF值差异无统计学意义(P>0.05);观察组E/A比值较对照组明显增加,E/Ea比值较对照组明显减少,差异均有统计学意义(P<0.05)。结论严重脓毒症可以导致明显的心肌损伤,影响心脏舒张功能,用磷酸肌酸治疗可减轻心肌损伤,保护心脏功能。

Objective To observe the myocardial protective function of creatine phosphate on patients with Sepsis as-sociated myocardial injury. Methods 240 patients with severe sepsis due to bowel perforation and abdominal infection were randomly devided into observation group and control group. All patients were given the Surgical treatment for the primary dis-ease,then got in ICU and received clinical monitoring. The observation group were given the creatine phosphate injection con-tinuously before and after operation of three days. Compared the creatine isoenzyme（ Ck-MB）,troponin I（ cTnI）,natriuretic peptide（ BNP）level changes of the two groups. And tested left ventricular ejection fraction（ LVEF）,ventricular diastolic func-tion：E/A,E/Ea by echocardiography. Results After treatment,the observation group Ck/MB,cTnI,BNP were lower than that of control group,the differences were statistically significant（P〈0. 05）;The difference of two groups＆#39;EF value was not statis-tically significant（P〉0. 05）;The E/A ratio of observation group was higher than the control group,and the E/Ea was lower than the control group,the difference were statistically significant（P〈0. 05）. Conclusion Severe sepsis can induce to myo-cardial injury,and affect cardiac diastolic function. Creatine phosphate can alleviate myocardial injury and protect heart func-tion.