特利加压素联合去甲肾上腺素对ICU脓毒性休克患者D-乳酸及心肌损伤指标的影响

Effects of Terlipressin Combined with Norepinephrine on D-lactic Acid and Myocardial Injury Indexes in Patients with Septic Shock in ICU

目的:探究特利加压素联合去甲肾上腺素对重症监护室(ICU)脓毒性休克患者D-乳酸及心肌损伤指标的影响。方法:回顾性选取2019年1月—2023年12月苏州大学附属第一医院收治的116例脓毒性休克患者,按治疗方法不同分为两组,各58例。两组均予以常规治疗,对照组予以去甲肾上腺素治疗,观察组在对照组基础上联合特利加压素治疗。比较两组D-乳酸、心肌损伤指标、肾功能、不良反应。结果:两组治疗前D-乳酸、心肌损伤指标、肾功能指标对比,差异均无统计学意义(P>0.05);观察组治疗36 h后D-乳酸、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)、N末端脑钠肽前体(NT-proBNP)、胱抑素C(CysC)、血肌酐(Scr)、血尿素氮(BUN)均较对照组低,差异均有统计学意义(P<0.05);两组不良反应发生率对比,差异无统计学意义(P>0.05)。结论:特利加压素联合去甲肾上腺素治疗ICU脓毒性休克患者可有效降低D-乳酸水平,改善肾功能,减轻心肌损伤,且安全可靠。

Objective:To investigate the effects of Terlipressin combined with Norepinephrine on D-lactic acid and myocardial injury indexes in patients with septic shock in intensive care unit(ICU).Method:A total of 116 patients with septic shock admitted to the First Affiliated Hospital of Soochow University from January 2019 to December 2023 were retrospectively selected and divided into two groups according to different treatment methods,with 58 cases in each group.Both groups were given routine treatment,the control group was given Norepinephrine treatment,and the observation group was combined with Terlipressin treatment on the basis of the control group.D-lactic acid,myocardial injury indexes,renal function and adverse reactions were compared between the two groups.Result:There were no significant differences in D-lactic acid,myocardial injury indexes and renal function indexes between the two groups before treatment(P>0.05).After 36 h of treatment,D-lactic acid,creatine kinase MB(CK-MB),cardiac troponin I(cTnI),N-terminal pro-brain natriuretic peptide(NT-proBNP),cystatin C(CysC),serum creatinine(Scr)and blood urea nitrogen(BUN)in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Terlipressin combined with Norepinephrine in the treatment of patients with septic shock in ICU can effectively reduce D-lactic acid level,improve renal function,alleviate myocardial injury,and is safe and reliable.