生脉注射液对心肌梗死合并心源性休克患者血液流变学及心脏泵功能的影响

Effects of Sheng Mai Injection on blood rheology and cardiac pump function in patients with myocardial infarction complicated with cardiac shock

目的:观察生脉注射液对心肌梗死合并心源性休克患者血液流变学及心脏泵功能的影响。方法:将2015-05-2016-06我院急诊科收治的196例心肌梗死合并心源性休克急诊患者均分为治疗组和观察组,治疗组常规用药急诊处理,观察组在急诊治疗基础上静滴生脉注射液。结果:观察组在治疗7d后全血低切黏度、全血高切黏度、红细胞压积、血小板集聚率、纤维蛋白原等血液流变学指标明显降低,患者舒张压(DP)升高、脉压差(PP)、左室最大上升/下降速率(±LV dp/dtmax)、左室舒张末内径(LVDD)和左心室射血分数(LVEF)增大,左室收缩末期内径(LVESD)缩小,肺毛细血管楔压(PCWP)降低,心脏指数(CI)和尿量增加,患者血清心肌肌钙蛋白I(CTNI)和cTNI-mRNA、cTNI-mRNA心肌钙调蛋白(CaMK)和钙调蛋白依赖性蛋白激酶Ⅱ(CaMKII)-mRNA均低表达,总有效率高于治疗组、肾功竭、心律失常等并发症和病死率低于治疗组,与治疗组比较,差异有统计学意义(均P<0.05)。结论:生脉注射液可显著改善血液流变学指标,增强心肌梗死合并心源性休克患者心脏泵血功能。

Objective：To observe Shengmai injection on hemorheology myocardial infarction and cardiac shock in patients.Method：One hundred and ninty-six cases of myocardial infarction and cardiac shock Taihe emergency patients admitted to the hospital emergency department were divided into treatment and observation groups,routine use of the drug treatment group,emergency treatment,the observation group in the emergency treatment based on intravenous Shengmai injection.Result：Observation group after treatment 7dlow shear whole blood viscosity,high shear whole blood viscosity,hematocrit,platelet aggregation rate,fibrinogen hemorheology significantly lower in patients with diastolic blood pressure（DP）increased pulse pressure difference（PP）,left ventricular maximum rise/fall rate（± LV dp/dtmax）,left ventricular end diastolic diameter（LVDD）and left ventricular ejection fraction（LVEF）increased left ventricular end systolic diameter（LVESD）reduced,pulmonary capillary wedge pressure（PCWP）decreased cardiac index（CI）and increase urine output,serum cardiac troponin I（cTNI）and cTNImRNA,cTNI-mRNA myocardial calmodulin（CaMK）and calmodulin-dependent protein kinase Ⅱ（CaMKII）-mRNA expression were low,there is always more efficient than the treatment group,exhaust renal,cardiac arrhythmias and other complications and mortality rate lower than the treatment group,compared with the treatment group,P〈0.05,the difference Statistical significance.Conclusion：Shengmai injection can significantly improve blood rheology,enhance patients with cardiogenic shock heart function.