参附注射液对急诊心肺复苏术后患者脏器功能的保护及改善预后的作用

Protective and Prognosis Effects of Shenfu Injection on Viscera Function in Patients Underwent Emergency Cardiopulmonary Resuscitation

目的:考察参附注射液对急诊心肺复苏术后患者脏器功能的保护及改善预后的作用。方法:82例心脏骤停的患者按照随机数字表法分为对照组(40例)和观察组(42例)。对照组患者在实施心肺复苏术的同时予以常规治疗;观察组患者在对照组治疗基础上加用参附注射液,于患者心肺复苏即刻静脉注射20 ml,每隔15 min注射1次,共5次,次日起静脉滴注100 ml(以0.9%氯化钠注射液稀释至400 ml),qd,共7 d。分别检测两组患者的C反应蛋白(CRP)、肿瘤坏死因子(TNF)-α、丙氨酸转氨酶(ALT)、尿肌酐(Cr)与肌酸激酶(CK)的水平,记录患者的平均动脉压和心率,按照格拉斯哥昏迷量表(GCS)对患者的昏迷程度进行评定,并观察不良反应发生情况。结果:在心肺复苏后24、48 h,观察组患者血清中的CRP与TNF-α水平均显著低于对照组,差异有统计学意义(P<0.05)。观察组患者在心肺复苏后6、12、48 h的平均动脉压显著高于对照组,在12、48 h的GCS评分显著高于对照组,差异均有统计学意义(P<0.05);两组患者各时点心率比较,差异无统计学意义(P>0.05)。观察组患者在心肺复苏后48、72 h的ALT、尿Cr和CK水平均显著低于对照组,差异有统计学意义(P<0.05)。两组患者均未见明显不良反应发生。结论:参附注射液对急诊心肺复苏术后患者的脏器功能具有一定的保护作用,并能改善患者的预后。

OBJECTIVE：To investigate the protective and prognosis effects of Shengfu injection on viscera function in patients underwent emergency cardiopulmonary resuscitation. METHODS：82 patients with cardiac arrest were randomly divided into control group（40 cases）and observation group（42 cases）. Both group received cardiopulmonary resuscitation and routine treatment;observation group was additionally given intravenous injection of Shenfu injection 20 ml immediately after cardiopulmonary resuscitation,every 15 min,5 times in total,100 ml via intravenous drip since the next day（0.9% Sodium chloride injection diluted to400 ml）,qd,for 7 days. CRP,TNF-α,ALT,urine Cr and CK levels were determined in two groups,respectively. Mean arterial pressure and heart rate were recorded,and coma degree was scored by using GCS,and ADR was observed. RESULTS：24 and 48 h after cardiopulmonary resuscitation,the serum levels of CRP and TNF-α in observation group were significantly lower than in control group,with statistical significance（P〈0.05）. 6,12 and 48 h after cardiopulmonary resuscitation,mean arterial pressure of observation group were significantly higher than that of control group,with statistical significance（P〈0.05）. 12,48 h after cardiopulmonary resuscitation,the GCS score in observation group was significantly higher than control group,with statistical significance（P〈0.05）. There was no statistical significance in heart rate between 2 groups at different time points（P〉0.05）. ALT,urine Cr and CK of observation group were all lower than those of control group 48 and 72 h after cardiopulmonary resuscitation,with statistical significance（P〈0.05）. No ADR was found in 2 groups. CONCLUSIONS：Shenfu injection shows a certain protective effect on viscera function in patients underwent cardiopulmonary resuscitation and improve prognosis.