参麦注射液联合血液灌流对脓毒症休克患者心肌抑制的影响

Effect of Shenmai Injection Combined with Hemoperfusion on Myocardial Inhibition of Septic Shock Patients

目的研究脓毒症休克患者采用参麦注射液联合血液灌流治疗对于保护心肌的作用,为参麦注射液在危重症患者治疗中的应用提供参考依据。方法选取2017年01月至2018年06月期间我院重症医学科收治的108例脓毒症心肌抑制患者(进入ICU时心脏超声左室射血分数<0.5)作为研究对象,按照随机数字表法将患者分为参麦组、联合组、对照组,对照组均按照临床诊疗指南治疗原发病,参麦组则增加应用参麦注射液,联合组采用参麦注射液联合血液灌流治疗,比较三组治疗效果。结果经过7 d的治疗,三组患者BNP、APACHEII评分、心肌抑制指标均有所改善,其中联合组患者BNP、APACHEII评分均显著低于对照组及参麦组,联合组心肌抑制指标改善情况优于对照组及参麦组(P<0.05);联合组28d生存率略高于对照组及参麦组,但组间28d生存率比较差异不大(P>0.05)。结论参麦注射液联合血液灌流治疗脓毒症休克患者具有改善心肌功能,减轻心肌抑制的作用,值得推广。

Objective To study effect of Shenmai injection combined with hemoperfusion on myocardial protection of septic shock patients, and provide reference for application of Shenmai injection in treatment of critically ill patients. Methods Choose 108 cases septic myocardial depression patients(left ventricular ejection fraction<0.5 entering ICU by echocardiography) admitted to ICU of our hospital from January 2017 to June 2018 as research objects. According to random number table method, divide them into Shenmai group, combination group and control group. Control group was treated with clinical diagnosis and treatment guidelines for primary diseases, shenmai group was added with Shenmai injection. Combination group was treated with Shenmai injection combined with hemoperfusion. Compare curative effect of three groups. Results 7 days after treatment, BNP, APACHEII scores and myocardial inhibition index of three groups were improved. BNP and APACHEII scores of combination group were significantly lower than control and Shenmai group, improvement of myocardial inhibition index of combination group was better than control and Shenmai group(P<0.05);28-day survival rate of combination group was slightly higher than control and Shenmai group, difference showed no significance between groups,(P> 0.05). Conclusion Shenmai injection combined with hemoperfusion can improve myocardial function and relieve myocardial inhibition of septic shock patients, which is worthy of promotion.