参附注射液对慢性心力衰竭急性失代偿合并心源性休克患者的血流动力学和临床疗效的影响

The effect of Shenfu injection on hemodynamics and clinical efficacy in patients with chronic heart failure,acute decompensation,and cardiogenic shock

目的观察参附注射液对慢性心力衰竭急性失代偿合并心源性休克患者的血流动力学和临床疗效的影响。方法选取2021年1月~2023年7月医院收治的慢性心力衰竭急性失代偿合并心源性休克患者60例,采用随机数字表法将其分为对照组(去甲肾上腺素)和观察组(去甲肾上腺素+参附注射液)各30例,观察两组治疗前后脉搏指示连续心排血量监测(PiCCO)血流动力学参数[每搏变异度(SVV)、心脏指数(CI)、全身血管阻力(SVRI)]、序贯器官衰竭估计评分(SOFA)、去甲肾上腺素用量、N末端B型脑钠肽前体(NT-proBNP)水平、超声心动图指标[左室短轴缩短率(LVFS)、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)]以及心血管复合终点事件发生率。结果观察组治疗后SVV低于对照组,CI、SVRI高于对照组(P<0.05);观察组治疗后SOFA评分、去甲肾上腺素用量低于对照组(P<0.05);观察组治疗后LVFS、LVEF高于对照组,LVEDD、NT-proBNP低于对照组(P<0.05);观察组治疗后LVFS、LVEF高于对照组,LVEDD低于对照组(P<0.05);观察组心源性死亡发生率为26.67%,对照组为40.00%,差异无统计学意义(P>0.05)。结论参附注射液在慢性心力衰竭急性失代偿合并心源性休克的治疗中,可以减少去甲肾上腺素使用量,具有较好的临床疗效。

Objective To observe the effects of Shenfu Injection on hemodynamics and clinical efficacy in patients with chronic heart failure,acute decompensation,and cardiogenic shock.Methods Sixty patients with chronic heart failure,acute decompensation,and cardiogenic shock admitted to the hospital from January 2021 to July 2023 were selected.They were randomly divided into a control group(norepinephrine)and an observation group(norepinephrine+Shenfu injection)using a random number table method,with 30 patients in each group,Observe the hemodynamic parameters(SVV,CI,SVRI),sequential organ failure assessment score(SOFA),norepinephrine dosage,N-terminal B-type brain natriuretic peptide precursor(NT-proBNP)levels before and after treatment in two groups of continuous cardiac output monitoring(PiCCO)with pulse indication before and after treatment Echocardiographic indicators[left ventricular short axis shortening rate(LVFS),left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD)],and the incidence of cardiovascular composite endpoint events.Results After treatment,the SVV of the observation group was lower than that of the control group,while the CI and SVRI were higher than those of the control group(P<0.05);After treatment,the SOFA score and norepinephrine dosage in the observation group were lower than those in the control group(P<0.05);After treatment,LVFS and LVEF in the observation group were higher than those in the control group,while LVEDD and NT-proBNP were lower than those in the control group(P<0.05);After treatment,LVFS and LVEF in the observation group were higher than those in the control group,while LVEDD was lower than that in the control group(P<0.05);The incidence of cardiac death was 26.67%in the observation group and 40.00%in the control group,with no statistically significant difference(P>0.05).Conclusions Shenfu Injection can reduce the use of norepinephrine in the treatment of acute decompensation combined with cardiogenic shock in chronic heart failure,and has good clinical efficacy.