早期联合参附注射液对心肺复苏患者心功能不全的临床观察

Clinical Observation of Early Combined with Shenfu Injection on Cardiac Insufficiency in Patients with Cardiopulmonary Resuscitation

目的:探讨早期联合参附注射液对心肺复苏患者心功能不全的临床疗效观察。方法:选取2015年1月至2017年1月在广西中医药大学第一附属医院急诊科和ICU住院的心脏骤停心肺复苏术后自主循环恢复的患者90例,采用回顾性病例分组,共分为三组,对照组予常规抢救药物干预,治疗A、B两组在此基础上加用参附注射液干预,治疗A组于心肺复苏早期基础生命支持阶段干预,治疗B组于心肺复苏中高级生命支持阶段干预。比较三组治疗前及治疗后24H、48H的Lee氏心衰积分、NT-proBNP、血清超敏C反应蛋白及生命征指标情况。结果:三组治疗后,Lee氏心衰积分、NT-proBNP、血清超敏C反应蛋白较前均降低。与对照组相比,治疗A、B组经SFI干预后NT-proBNP、血清超敏C反应蛋白水平较对照组明显下降,P<0.0001,且A、B组比较,A组优于B组,P<0.05;经治疗24H、48H后,治疗A、B组均优于治疗组,且A、B两组平均动脉压、呼吸频率、血氧饱和度及心率各值比较,A组优于B组,P<0.05。结论:在心肺复苏后心功能不全患者治疗中,于心肺复苏早期基础生命支持阶段联合参附注射液干预可一定程度上缓解心衰症状,降低NT-proBNP、血清超敏C反应蛋白水平,维持生命征平稳,这可能与参附注射液可抑制机体炎症反应、减轻复苏后心肌损伤、调节RASS系统相关,但具体作用机制有待深入探析。

Objective:To investigate the clinical effect of early combined Shenfu Injection on cardiac insufficiency in patients with cardiopulmonary resuscitation.Methods:Ninety patients with cardiac arrest and cardiopulmonary resuscitation who recovered spontaneous circulation after cardiopulmonary resuscitation were selected from January 2015 to January 2017 in the emergency department and ICU of the First Affiliated Hospital of Guangxi University of Chinese Medicine.The patients were divided into three groups by retrospective case grouping.The control group was given routine rescue drug intervention.Treatment group A and group B on this basis with Shenfu Injection intervention.Treatment group A in the early basic life support stage of cardiopulmonary resuscitation intervention.Group B was treated with advanced life support intervention in cardiopulmonary resuscitation.Lee's heart failure score,NT-proBNP,serum hypersensitive C-reactive protein and vital signs were compared before and after treatment for 24H and 48H.Results:After treatment,Lee's heart failure score,NT-proBNP and serum hypersensitive C-reactive protein were all lower than before.Compared with the control group,Lee's heart failure score,NT-proBNP and serum hypersensitive C-reactive protein in group A and B decreased significantly(P<0.05);after 24H and 48H treatment,the mean arterial pressure,respiratory rate,oxygen saturation and heart rate in group A and B were higher than those in group B before treatment,and the average arterial pressure in group A and B was significantly higher than that in group B.The blood pressure,respiratory rate,oxygen saturation and heart rate of group A were significantly improved,and group A was better than group B,(P<0.0001).Conclusion:In the treatment of patients with cardiac insufficiency after cardiopulmonary resuscitation,the intervention of Shenfu Injection in the early basic life support stage of cardiopulmonary resuscitation can alleviate the symptoms of heart failure to a certain extent,reduce the levels of NT-proBNP and serum hypersensitive C-reactive protein,and maintain the stability of vital signs.This may be related to Shenfu Injection which can inhibit the body's inflammatory reaction and reduce it.Myocardial injury and regulation of RASS system after mild resuscitation are related,but the specific mechanism needs to be further explored.