低剂量氢化可的松对脓毒性休克早期心肌的保护作用

Protective effect of low-dose Hydrocortisone on myocardium in early septic shock

目的:分析低剂量氢化可的松对脓毒性休克早期心肌的保护作用。方法:选取习水县人民医院重症医学科2021年1月—2023年3月收治的脓毒性休克患者76例,采用随机数字表法分为对照组与观察组各38例。对照组实施常规治疗;观察组在对照组治疗基础上实施低剂量氢化可的松治疗;对比两组心脏功能、心肌损伤标志物、循环指标、心肌酶谱及炎症因子水平等指标变化情况。结果:治疗前,两组心脏功能、心肌损伤标志物、循环指标、心肌酶谱及炎症因子水平等指标对比,差异无统计学意义(P>0.05)。治疗后,两组N-末端原脑利钠肽(NT-proBNP)对比,差异无统计学意义(P>0.05);但观察组平均动脉压(MAP)高于对照组,心率(HR)、心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、肌酸激酶(CK)低于对照组,差异有统计学意义(P<0.05)。观察组炎症因子(CRP、PCT、WBC)均低于对照组,差异有统计学意义(P<0.05)。结论:低剂量氢化可的松对脓毒性休克早期心肌具有一定保护作用,能减轻患者机体炎症水平,值得临床应用。

Objective To analyze the protective effect of low-dose hydrocortisone on early myocardial protection in severe sepsis.Methods Seventy six patients with severe sepsis admitted to our hospital from January 2021 to March 2023 were collected.They were divided into two groups with the use of random-number tables,with thirty eight cases in the control group and thirty eight cases in the observation group.The control group received routine treatment,while the observation group received lowdose hydrocortisone treatment based on routine treatment.The changes of various indicators including heart function,myocardial injury markers,cardiovascular indicators,myocardial enzymes,and inflammation factors were compared between the two groups.Results There were no statistical differences in cardiac function,myocardial injury markers,circulation indexes,myocardial enzyme profiles and inflammatory factors before treatment(P>0.05).There was no difference in N-terminal probrain natriuretic peptide(NT-proBNP)after treatment(P>0.05).However,the average arterial pressure(MAP)in observation group was higher than that in control group,and the heart rate(HR),cardiac troponin Ⅰ(cTnⅠ),creatine kinase isoenzyme(CK-MB)and creatine kinase(CK)were lower than those in control group(P<0.05).The inflammatory factors(CRP,PCT and WBC)in observation group were lower than those in control group(P<0.05).Conclusion Low-dose hydrocortisone has a certain protective effect on early myocardial protection in severe sepsis and reduces the body’s inflammatory level.It is worth promoting.