左西孟旦和多巴酚丁胺治疗对急性心肌梗死并发心源性休克患者血清学指标的影响

Influecne of levosimendan and dobutamine treatment on serum markers of patients with acute myocardial infarction complicated by cardiogenic shock

目的:研究左西孟旦和多巴酚丁胺治疗对急性心肌梗死并发心源性休克患者血清学指标的影响。方法:选择在本院确诊为急性心肌梗死合并心源性休克的患者80例进行研究,随机分为左西孟旦组和多巴酚丁胺组,治疗后采集血清并检测心肌酶指标、神经体液指标以及炎症应激指标。结果:(1)心肌酶:与多巴酚丁胺组比较,左西孟旦组的血清肌酸激酶同工酶(CK-MB)、肌钙蛋白C(cTnT)含量较低;(2)神经体液指标:与多巴酚丁胺组比较,左西孟旦组的血清去甲肾上腺素(NE)、R、血管紧张素II(Ang II)、ALD、N末端B型利钠肽原(NT-proBNP)的含量较低;(3)炎症和内质网应激指标:与多巴酚丁胺组比较,左西孟旦组的血清中Fractalkine、CX3CR1、GRP78和GRP94的含量较低。结论:左西孟旦治疗有助于保护心肌细胞、改善神经体液指标、缓解炎症反应和内质网应激,是治疗急性心肌梗死并发心源性休克的理想方法。

Objective：To study the influence of levosimendan and dobutamine treatment on serum markers of patients with acute myocardial infarction complicated by cardiogenic shock.Methods：A total of 80 patients diagnosed of acute myocardial infarction complicated by cardiogenic shock treated in our hospital were selected and randomly divided into levosimendan group and dobutamine group.Serum was collected after treatment and myocardial enzyme indexes,neurohumonal indexes and inflammation stress indexes were detected.Results：（1）Myocardial enzymes：compared with dobutamine group,serum CKMB and cTnT contents of levosimendan group were significant lower;（2）Neurohumoral indexes：compared with dobutamine group,serum NE,R,AngII,ALD and NT-proBNP contents of levosimendan group were significant lower;（3）Inflammation and endoplasmic reticulum stress indexes：compared with dobutamine group,serum Fractalkine,CX3CR1,GRP78 and GRP94contents of levosimendan group were significant lower.Conclusion：Levosimendan treatment is helpful to protect myocardial cells,improve neurohumoral indexes and relieve inflammation and endoplasmic reticulum stress;it＇s an ideal treatment for acute myocardial infarction complicated by cardiogenic shock.