盐酸纳美芬注射液辅助治疗脓毒性休克合并心肌损伤的临床研究

Clinical Study of Nalmefene Hydrochloride Injection in the Adjuvant Treatment of Septic Shock Complicated with Myocardial Injury

目的:探讨盐酸纳美芬注射液辅助治疗脓毒性休克合并心肌损伤的临床效果。方法:选取2021年1月—2022年2月廊坊市人民医院收治的脓毒性休克合并心肌损伤患者78例为研究对象,根据随机数字表法分为对照组和试验组,各39例。对照组予以早期规范化液体复苏治疗,试验组在对照组基础上进行盐酸纳美芬注射液辅助治疗。比较两组心肌损伤标志物、血流动力学指标、尿量。结果:治疗12 h和治疗24 h,试验组氨基末端脑钠肽前体、肌钙蛋白I、肌酸激酶同工酶及肌酸激酶水平低于对照组,差异有统计学意义(P<0.05);治疗后,两组心率(HR)、血乳酸降低,平均动脉压(MAP)、尿量升高,试验组HR、血乳酸低于对照组,MAP、尿量高于对照组,差异有统计学意义(P<0.05)。结论:液体复苏治疗联合盐酸纳美芬注射液治疗脓毒性休克心肌损伤患者效果较好,可有效保护心肌,改善血流动力学及尿量。

Objective:To investigate the clinical effect of nalmefene hydrochloride injection in the adjuvant treatment of septic shock complicated with myocardial injury.Methods:A total of seventy-eight patients with septic shock combined with myocardial injury admitted to Langfang People's Hospital from January 2021 to February 2022 were selected as the study objects,and were divided into control group and experimental group according to random number table method,with thirty-nine cases in each group.The control group was given early standardized liquid resuscitation treatment,and the experimental group received nalmefene hydrochloride injection adjuvant treatment on the basis of the control group.Myocardial injury markers,hemodynamic indexes and urine volume were compared between the two groups.Results:After treatment for 12 h and 24 h,the levels of amino terminal brain natriuretic peptide precursor,troponin I,creatine kinase isoenzyme and creatine kinase in experimental group were lower than those in control group,with statistical significance(P<0.05);after treatment,heart rate(HR)and blood lactic acid decreased,mean arterial pressure(MAP)and urine volume increased,and HR and blood lactic acid in experimental group were lower than those in control group,MAP and urine volume were higher than control group,the difference was statistically significant(P<0.05).Conclusion:Liquid resuscitation combined with nalmefene hydrochloride injection is effective in the treatment of myocardial injury in septic shock patients,which can effectively protect myocardium and improve hemodynamics and urine volume.