参附注射液联合血必净注射液对脓毒症心肌病患者循环和毛细血管充盈时间的影响

Effects of Shenfu Injection combined with Xuebijing Injection on circulation and capillary filling time in patients with sepsis-induced cardiomyopathy

目的 评价参附注射液加血必净注射液对(脓毒症心肌病SIC)患者循环和毛细血管充盈时间的影响。方法 将87例SIC患者随机分为治疗组和对照组,对照组44例,治疗组43例。对照组患者给予脓毒症集束化治疗;治疗组在对照组的基础上给予血必净注射液加参附注射液静脉滴注,两组疗程均为3 d。评估病情和预后指标(APACHEⅡ评分、SOFA评分)、心肌损伤标志物(cTnT、NT-ProBNP)、血流动力学指标(MAP、CVP、CI)、微循环指标(Lac、24 h Lac清除率、CRT)。结果 治疗后,两组APACHEⅡ评分、SOFA评分、cTnT、NT-ProBNP、Lac、CRT均降低(P<0.05),均以治疗组更明显(P<0.05),24 h Lac清除率治疗组高于对照组(P<0.05)。治疗后两组患者MAP、CVP较治疗前均升高,治疗后24、48、72 h,治疗组CI高于照组;治疗后第6、24 h,治疗组患者Lac低于对照组(P<0.05);治疗后第3、6、24 h,治疗组患者CRT低于对照组(P<0.05)。结论 在西医常规集束化治疗的基础上,加用参附注射液和血必净注射液治疗,可改善微循环及血流动力学,抑制心肌损伤,有利于改善SIC患者的心功能。

Objective Evaluate the effects of Shenfu Injection and Xuebijing Injection on circulation and capillary filling time in sepsis-induced cardiomyopathy(SIC)patients.Methods 87 SIC patients were randomly divided into the treatment group and control group,with 44 cases in the control group and 43 cases in the treatment group.The control group patients were treated with bundle therapy for sepsis;The treatment group received intravenous infusion of Xuebijing Injection and Shenfu Injection on the basis of bundle therapy,and both groups had a treatment period of 3 days.Evaluate the condition and prognostic indicators(APACHEⅡscore,SOFA score),myocardial injury markers(cTnT,NT-ProBNP),hemodynamic indicators(MAP,CVP,CI),microcirculation indicators(Lac,24-hour Lac clearance rate,CRT).Results After treatment,the APACHEⅡscore,SOFA score,cTnT,NT-ProBNP,Lac,and CRT in both groups decreased(P<0.05),with the treatment group showing a more significant decrease(P<0.05).The 24-hour Lac clearance rate in the treatment group was higher than that in the control group(P<0.05).After treatment,the MAP and CVP of both groups of patients increased compared to before treatment.At 24,48,and 72 h after treatment,the CI of the treatment group was higher than that of the control group.At 6 and 24 h after treatment,the Lac in the treatment group was lower than that in the control group(P<0.05),and at 3,6,and 24 h after treatment,the CRT in the treatment group was lower than that in the control group(P<0.05).Conclusion On the basis of conventional bundle therapy in Western medicine,the addition of Shenfu Injection and Xuebijing Injection can improve microcirculation and hemodynamics,inhibit myocardial injury,and be beneficial for improving heart function of SIC patients.