目的探讨艾司洛尔对脓毒性休克患者的心脏保护作用。方法选取浙江省立同德医院收治的44例脓毒性休克患者,采用随机数字表法分为对照组(22例)和治疗组(22例)。治疗组在常规治疗基础上静脉泵入艾司洛尔,对照组持续静脉泵入等渗NaCl溶液。...目的探讨艾司洛尔对脓毒性休克患者的心脏保护作用。方法选取浙江省立同德医院收治的44例脓毒性休克患者,采用随机数字表法分为对照组(22例)和治疗组(22例)。治疗组在常规治疗基础上静脉泵入艾司洛尔,对照组持续静脉泵入等渗NaCl溶液。记录两组患者入组后0、24、48、72、96 h时的心率、中心静脉压(CVP)、平均动脉压(MAP)、每搏量指数(SVI)、心脏指数、全心舒张末期血容积指数(GEDVI)、左室射血分数(LVEF)、二尖瓣口舒张早晚期血流峰值流速比值(E/A)、心肌肌钙蛋白I(cTnI)、脑钠尿肽、血乳酸和ScvO_2表达水平,比较两组患者的28 d病死率。结果两组患者各时间点心率、心脏指数、GEDVI、E/A、cTnI及脑钠尿肽表达水平比较,差异均有统计学意义(F=58.045、11.102、7.132、7.136、2.970、3.006,P均<0.05)。进一步两两比较发现,治疗组患者24、48、72及96 h心率和心脏指数较对照组同时间点及治疗组0 h均显著降低(P均<0.05);治疗组患者48、72及96 h GEDVI及E/A水平较对照组同时间点及治疗组0 h均显著升高(P均<0.05);治疗组患者48、72及96 h cTnI和脑钠尿肽表达水平均较对照组同时间点显著降低(P均<0.05);治疗组患者72及96 h cTnI和脑钠尿肽表达水平均较同组0 h显著降低(P均<0.05)。且对照组及治疗组患者28 d病死情况比较,差异无统计学意义(7/22 vs. 5/22,χ~2=0.458,P=0.498)。结论艾司洛尔可减轻脓毒性休克患者心肌损伤,改善心肌舒张功能,对循环、组织灌注及氧代谢无影响,对预后无显著改变。展开更多
Objective To investigate the effect of the combined therapy of electroacupuncturing Zusanli(ST36)and umbilical compression with Dachengqi Decoction on septic patients with intestinal dysfunction in reducing inflammati...Objective To investigate the effect of the combined therapy of electroacupuncturing Zusanli(ST36)and umbilical compression with Dachengqi Decoction on septic patients with intestinal dysfunction in reducing inflammation index,protecting intestinal mucosal barrier function and improving the prognosis of disease.Methods Totally 70 septic patients with intestinal dysfunction(Yangming visceral syndrome)were randomly assigned to treatment group and control group,35 in each group.Patients in the control group were administered with routine treatment of Western medicine,and as for the treatment group,electroacupuncturing Zusanli(ST36)combined with umbilical compression with Dachengqi Decoction were applied based on routine treatment.All treatment course lasted for 5 days.Before treatment and at 1st,3rd and 7th day of treatment,the levels of procalcitonin(PCT),TNF-α,intestinal fatty acid binding protein(IFABP),citrulline,D-lactic acid and intra-abdominal pressure(IAP)were observed.The duration of mechanical ventilation,stay in ICU and the 28th day survival were recorded.The correlation with the level of inflammatory factors and the serum markers of intestinal function was analyzed.Results Compared with those before treatment,although the level of TNF-α was not significantly decreased in the control group at 1st day of treatment,the levels of PCT,TNF-α,IFABP,D-lactic acid and IAP decreased at all time points after treatment in the two groups,and the level of citrulline increased(P<0.05).Compared with those of the 1st day after treatment,the levels of PCT,TNF-α,IFABP,D-lactic acid and IAP decreased in the two groups at 3rd and 7th day of treatment,and the levels of citrulline were increased at the 3rd and 7th day after treatment,the levels of PCT,TNF-α,IFABP,D-lactic acid,citrulline and IAP were better at the 7th day than the 3rd day in the two groups(P<0.05).Compared with the control group,the levels of PCT,TNF-,IFABP,D-lactic acid and IAP in the treatment group all decreased and the level of citrulline increased at time points after treatment(P<0.05).There were no statistical differences in duration of mechanical ventilation,stay in ICU and the 28th day mortality between the two groups(P>0.05).The plasma level of IFABP,citrulline,D-lactic acid and IAP were pairwise correlated(P<0.01),all of which had significant correlation with the level of serum PCT and TNF-α(P<0.01),and there was no significant correlation with duration of mechanical ventilation and stay in ICU.Conclusion Electroacupuncturing Zusanli(ST36)combined with umbilical compression with Dachengqi Decoction could relieve the inflammatory response and protect their intestinal barrier functions in septic patients with intestinal dysfunction.展开更多
文摘目的探讨艾司洛尔对脓毒性休克患者的心脏保护作用。方法选取浙江省立同德医院收治的44例脓毒性休克患者,采用随机数字表法分为对照组(22例)和治疗组(22例)。治疗组在常规治疗基础上静脉泵入艾司洛尔,对照组持续静脉泵入等渗NaCl溶液。记录两组患者入组后0、24、48、72、96 h时的心率、中心静脉压(CVP)、平均动脉压(MAP)、每搏量指数(SVI)、心脏指数、全心舒张末期血容积指数(GEDVI)、左室射血分数(LVEF)、二尖瓣口舒张早晚期血流峰值流速比值(E/A)、心肌肌钙蛋白I(cTnI)、脑钠尿肽、血乳酸和ScvO_2表达水平,比较两组患者的28 d病死率。结果两组患者各时间点心率、心脏指数、GEDVI、E/A、cTnI及脑钠尿肽表达水平比较,差异均有统计学意义(F=58.045、11.102、7.132、7.136、2.970、3.006,P均<0.05)。进一步两两比较发现,治疗组患者24、48、72及96 h心率和心脏指数较对照组同时间点及治疗组0 h均显著降低(P均<0.05);治疗组患者48、72及96 h GEDVI及E/A水平较对照组同时间点及治疗组0 h均显著升高(P均<0.05);治疗组患者48、72及96 h cTnI和脑钠尿肽表达水平均较对照组同时间点显著降低(P均<0.05);治疗组患者72及96 h cTnI和脑钠尿肽表达水平均较同组0 h显著降低(P均<0.05)。且对照组及治疗组患者28 d病死情况比较,差异无统计学意义(7/22 vs. 5/22,χ~2=0.458,P=0.498)。结论艾司洛尔可减轻脓毒性休克患者心肌损伤,改善心肌舒张功能,对循环、组织灌注及氧代谢无影响,对预后无显著改变。
文摘Objective To investigate the effect of the combined therapy of electroacupuncturing Zusanli(ST36)and umbilical compression with Dachengqi Decoction on septic patients with intestinal dysfunction in reducing inflammation index,protecting intestinal mucosal barrier function and improving the prognosis of disease.Methods Totally 70 septic patients with intestinal dysfunction(Yangming visceral syndrome)were randomly assigned to treatment group and control group,35 in each group.Patients in the control group were administered with routine treatment of Western medicine,and as for the treatment group,electroacupuncturing Zusanli(ST36)combined with umbilical compression with Dachengqi Decoction were applied based on routine treatment.All treatment course lasted for 5 days.Before treatment and at 1st,3rd and 7th day of treatment,the levels of procalcitonin(PCT),TNF-α,intestinal fatty acid binding protein(IFABP),citrulline,D-lactic acid and intra-abdominal pressure(IAP)were observed.The duration of mechanical ventilation,stay in ICU and the 28th day survival were recorded.The correlation with the level of inflammatory factors and the serum markers of intestinal function was analyzed.Results Compared with those before treatment,although the level of TNF-α was not significantly decreased in the control group at 1st day of treatment,the levels of PCT,TNF-α,IFABP,D-lactic acid and IAP decreased at all time points after treatment in the two groups,and the level of citrulline increased(P<0.05).Compared with those of the 1st day after treatment,the levels of PCT,TNF-α,IFABP,D-lactic acid and IAP decreased in the two groups at 3rd and 7th day of treatment,and the levels of citrulline were increased at the 3rd and 7th day after treatment,the levels of PCT,TNF-α,IFABP,D-lactic acid,citrulline and IAP were better at the 7th day than the 3rd day in the two groups(P<0.05).Compared with the control group,the levels of PCT,TNF-,IFABP,D-lactic acid and IAP in the treatment group all decreased and the level of citrulline increased at time points after treatment(P<0.05).There were no statistical differences in duration of mechanical ventilation,stay in ICU and the 28th day mortality between the two groups(P>0.05).The plasma level of IFABP,citrulline,D-lactic acid and IAP were pairwise correlated(P<0.01),all of which had significant correlation with the level of serum PCT and TNF-α(P<0.01),and there was no significant correlation with duration of mechanical ventilation and stay in ICU.Conclusion Electroacupuncturing Zusanli(ST36)combined with umbilical compression with Dachengqi Decoction could relieve the inflammatory response and protect their intestinal barrier functions in septic patients with intestinal dysfunction.
