發(fā)布時(shí)間：2018-09-14 11:38

【摘要】：目的觀察給予膿毒癥患者重組人腦利鈉肽(recombinant human brain natriuretic peptide,rhBNP)治療后血清氮末端-前腦鈉肽(N-terminal pro-B-type natriuretic peptide,NtproBNP)、肌鈣蛋白(cTnI)、左室射血分?jǐn)?shù)(LVEF)隨時(shí)間的變化,探討rhBNP對(duì)膿毒癥誘導(dǎo)心功能障礙的干預(yù)效應(yīng)。方法收集2013年2月至2015年5月期間我院重癥醫(yī)學(xué)科收治的膿毒癥患者資料40例,隨機(jī)均分為對(duì)照組和rhBNP組,兩組患者除目標(biāo)導(dǎo)向治療(EGDT)外,rhBNP組靜脈推注rhBNP 1.5μg/kg,后以0.075μg·kg-1·min-1持續(xù)泵入48h;對(duì)照組予以等容量生理鹽水。在治療過(guò)程中,可使用血管活性藥物維持BP。兩組患者分別于治療前、治療后第1、3、7天時(shí)采血行即時(shí)檢驗(yàn)(point of care,POCT),檢測(cè)血漿Nt-proBNP、肌鈣蛋白I(cTnI);并同時(shí)于床旁行經(jīng)胸心臟超聲測(cè)定LVEF。結(jié)果治療后第1、3天rhBNP組Nt-proBNP水平和cTnI明顯低于對(duì)照組(P0.05),治療后第3天兩組Nt-proBNP水平和cTnI明顯高于第1天和第7天(P0.01)。治療后第3、7天rhBNP組LVEF明顯高于對(duì)照組(P0.05或P0.01);治療后第3天兩組LVEF明顯低于治療前和第7天(P0.05或P0.01)。結(jié)論 rhBNP能降低膿毒癥患者Nt-proBNP及cTnI,提高LVEF,顯著改善膿毒癥誘導(dǎo)的心功能障礙。
[Abstract]:Objective to observe the changes of serum nitrogen-forebrain natriuretic peptide (N-terminal pro-B-type natriuretic peptide,NtproBNP) and left ventricular ejection fraction (LVEF) of troponin (cTnI), after treatment with recombinant human brain natriuretic peptide (recombinant human brain natriuretic peptide,rhBNP) in septic patients. To investigate the effect of rhBNP on septic induced cardiac dysfunction. Methods from February 2013 to May 2015, 40 patients with sepsis were randomly divided into control group and rhBNP group. The patients in both groups were injected with rhBNP 1.5 渭 g / kg by intravenous injection, then continuously pumped with 0.075 渭 g kg-1 min-1 for 48 h, and those in the control group were given normal saline of equal volume. During treatment, vasoactive drugs can be used to maintain BP. Blood samples were collected before treatment and 3 days after treatment for immediate (point of care,POCT), plasma Nt-proBNP, troponin I (cTnI); was detected and transthoracic echocardiography was performed to determine LVEF. at the same time. Results the levels of Nt-proBNP and cTnI in the rhBNP group were significantly lower than those in the control group on day 1 and day 3 after treatment (P0.05), and the levels of Nt-proBNP and cTnI in the two groups on the 3rd day after treatment were significantly higher than those on the 1st and 7th day (P0.01). The LVEF of the rhBNP group was significantly higher than that of the control group on the 3rd day after treatment (P0.05 or P0.01), and the LVEF of the two groups on the 3rd day after treatment was significantly lower than that before treatment and on the 7th day (P0.05 or P0.01). Conclusion rhBNP can decrease Nt-proBNP and increase LVEF, in septic patients.
【作者單位】： 四川省人民醫(yī)院重癥醫(yī)學(xué)科;
【分類(lèi)號(hào)】：R459.7

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