不同的镇痛方案为基础的浅镇静对脓毒症心肌病患者炎症反应及心肌损伤的影响

Effects of shallow sedation based on different analgesic regimens on inflammation and myocardial injury in patients with sepsis cardiomyopathy

目的探讨不同的镇痛方案为基础的浅镇静对脓毒症心肌病患者炎症反应及心肌损伤的影响。方法回顾性分析2018年3月至2020年3月河南科技大学附属许昌市中心医院收治的80例脓毒症心肌病患者临床资料,根据镇痛方案的不同分为对照组(芬太尼)和观察组(瑞芬太尼),各40例。比较两组治疗前、治疗3 d后炎症反应[包括血清降钙素原(PCT)、C反应蛋白(CRP)水平]及心肌功能[包括心肌肌钙蛋白T (cTnT)、氨基末端B型钠尿肽前体(NT-proBNP)水平]。结果两组治疗后PCT、CRP、cTnT、NT-proBNP水平均下降,且观察组较低,差异有统计学意义(P<0.05)。结论以瑞芬太尼镇痛为基础的浅镇静可缓解脓毒症心肌病患者炎症反应,减轻其心肌损伤。

【Objective】To explore the effect of shallow sedation based on different analgesic regimens on inflammation and myocardial injury in patients with sepsis cardiomyopathy.【Methods】The clinical data of 80 patients with sepsis cardiomyopathy who were received in our hospital from March 2018 to March 2020 were retrospectively analyzed,and they were divided into a control group(fentanyl)and an observation group(remifentanil)according to different analgesic protocols,40 cases each.The inflammatory response including serum procalcitonin(PCT),C-reactive protein(CRP)levels and myocardial function including cardiac troponin T(cTnT),amino-terminal B-type natriuretic peptide precursor(NT-proBNP)levels before and after 3 days of treatment between the two groups were compared.【Results】After treatment,the levels of PCT,CRP,cTnT and NT-proBNP decreased,and the observation group was lower,the difference was statistically significant(P<0.05).【Conclusion】Shallow sedation based on remifentanil analgesia can alleviate inflammation and reduce myocardial damage in patients with sepsis cardiomyopathy.