地高辛注射液联合米力农注射液治疗脓毒症心功能障碍的临床观察

Clinical Study of Digoxin injection combined with Milrinone injection in the Treatment of Sepsis-induced Myocardial Dysfunction

目的:探讨地高辛注射液联合米力农注射液治疗脓毒症心功能障碍的临床疗效。方法:将2020年1月至2020年12月天津市人民医院重症医学科收治的脓毒症心功能障碍的患者53例按照随机数字表法分为对照组(n=30)和观察组(n=23),两组均按脓毒症和脓毒症心功能障常规治疗,对照组给予米力农注射液持续治疗7日;观察组在对照组的治疗基础上加用地高辛注射液治疗,隔日给药(即第1、3、5日)。比较两组治疗前后全身症状评分和SOFA评分、心率、24 h尿量、血浆B型脑钠肽(BNP)、肌钙蛋白I(cTnI)、左心室射血分数(LVEF)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、动脉血乳酸(LAC)、降钙素原(PCT)和总有效率。结果:观察组治疗后脓毒症心功能障碍的临床症状改善、心率控制、增加尿量、BNP、cTnI、PaO2、LAC、LVEF及总有效率均明显优于对照组,P均<0.05。结论:地高辛注射液联合米力农注射液治疗脓毒症心功能障碍较单用米力农的疗效显著。

Objective:To explore the clinical efficacy of digoxin injection combined with milrinone injection in the treatment of sepsis-induced myocardial dysfunction.Methods:53 patients with sepsis-induced myocardial dysfunction were divided into the control group(n=30)and the observation group(n=23)accorded to the random number table method from Jan 2020 to Dec 2020 at Department of Critical Care Medicine of Tianjin Union Medical Center.On the basis of sepsis and cardiac dysfunction routine treatment,the patients in the control group were treated with milrinone injection for 7 days;while the patients in the observation group were treated with digoxin injection besides treatment applied in the control group,digoxin injection was given every other day(i.e.the first,third,fifth day).The systemic symptom score,SOFA score,heart rate,24-hour urine volume,plasma B-type brain natriuretic peptide(BNP),troponin I(c TnI),left ventricular ejection fraction(LVEF),arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),arterial blood lactic acid(LAC),procalcitonin(PCT)and total effective rate were compared between the two groups before and after treatment.Results:The systemic symptom score,SOFA score,heart rate,24-hour urine volume,BNP,cTnI,LVEF,PaO2,PaCO2,LAC,PCT and total effective rate in the observation group were significantly better than those in the control group after treatment,all P<0.05.Conclusion:It is better that digoxin injection combined with milrinone injection in the treatment of sepsis-induced myocardial dysfunction compared with milrinone injection only.