本文關(guān)鍵詞：環(huán)磷腺苷葡胺聯(lián)合地高辛治療膿毒癥致心肌頓抑性心力衰竭的療效分析　出處：《中國全科醫(yī)學(xué)》2017年17期 　論文類型：期刊論文

  更多相關(guān)文章： 膿毒癥 心肌頓抑 心力衰竭 環(huán)磷腺苷葡胺 地高辛

【摘要】：目的探討環(huán)磷腺苷葡胺聯(lián)合地高辛治療膿毒癥致心肌頓抑性心力衰竭的療效。方法選取2013年1月—2015年6月安徽醫(yī)科大學(xué)附屬宿州醫(yī)院急診科和全科醫(yī)學(xué)科收治的膿毒癥致心肌頓抑性心力衰竭患者58例,采用隨機數(shù)字表法分為治療組29例和對照組29例,兩組均予常規(guī)對癥治療,治療組在常規(guī)治療基礎(chǔ)上加用5%葡萄糖注射液250 ml+環(huán)磷腺苷葡胺180 mg+胰島素4 U,靜脈滴注;地高辛0.125 mg,口服,1次/d。對照組加用地高辛0.125mg,口服,1次/d。兩組患者分別于治療前、治療后第7天抽靜脈血和/或動脈血查心肌肌鈣蛋白I(c Tn-I)、腦鈉肽(BNP)、C反應(yīng)蛋白(CRP)、血乳酸(Lac)、降鈣素原(PCT),并進行急性生理與慢性健康狀況評分系統(tǒng)Ⅱ(APACHEⅡ評分)及床旁彩超檢測左心室射血分數(shù)(LVEF)。結(jié)果兩組患者治療前c Tn-I、BNP、CRP、Lac、PCT水平、APACHEⅡ評分、LVEF比較,差異均無統(tǒng)計學(xué)意義(P0.05);治療后治療組c Tn-I、BNP、CRP、Lac、PCT水平、APACHEⅡ評分低于對照組,LVEF高于對照組(P0.05)。兩組不良反應(yīng)發(fā)生率比較,差異無統(tǒng)計學(xué)意義[44.8%(13/29)與51.7%(15/29),χ~2=0.276,P=0.599];兩組2周后病死率比較,差異有統(tǒng)計學(xué)意義[34.5%(10/29)與10.3%(3/29),χ~2=4.858,P=0.028]。結(jié)論環(huán)磷腺苷葡胺聯(lián)合地高辛治療膿毒癥致心肌頓抑性心力衰竭,可明顯減輕心肌損傷及全身炎性反應(yīng),改善心功能,降低病死率。
[Abstract]:Objective to investigate the therapeutic effect of McAMP combined with digoxin in the treatment of sepsis induced myocardial stunning in congestive heart failure. Methods the emergency department of Suzhou Hospital Affiliated to Medical University Of Anhui from January 2013 to June 2015 and the Department of family medicine from sepsis induced myocardial stunning of heart failure in patients with 58 cases, were randomly divided into treatment group of 29 cases and the control group of 29 cases, two groups were given conventional symptomatic treatment, the treatment group was treated with 5% Glucose Injection ml+ 250 on the basis of routine treatment of meglumine adenosine cyclophosphate 180 mg+ insulin 4 U, intravenous injection; digoxin 0.125 mg orally, 1 times /d., the control group was treated with digoxin orally, 1 0.125mg, two /d. groups of patients respectively before treatment, after treatment seventh days. Venous blood and / or arterial blood check of cardiac troponin I (C Tn-I), brain natriuretic peptide (BNP), C reactive protein (CRP), blood lactate (Lac), procalcitonin (PCT), and acute physiology and chronic Sexual health evaluation II (APACHE II) and bedside ultrasound detection of left ventricular ejection fraction (LVEF). The results of two groups of patients before treatment, C Tn-I, BNP, CRP, Lac, PCT level, APACHE score, LVEF, showed no significant difference (P0.05); the treatment group after treatment C Tn-I, BNP, CRP, Lac, PCT level, APACHE score lower than the control group, LVEF was higher than the control group (P0.05). The adverse effects of the two groups, there was no significant difference between [44.8% (13/29) and 51.7% (15/29), X ~2=0.276, P=0.599]; the two group after 2 week mortality rate comparison, difference there was statistical significance in [34.5% (10/29) and 10.3% (3/29), X ~2=4.858, P=0.028]. conclusion McAMP combined with digoxin in the treatment of sepsis induced myocardial stunning of heart failure, can significantly reduce myocardial injury and systemic inflammatory response, improve heart function, reduce the mortality rate.

【作者單位】： 安徽醫(yī)科大學(xué)附屬宿州醫(yī)院
【分類號】：R459.7;R541.6
【正文快照】： 膿毒癥是急診重癥患者的常見疾病,嚴重的膿毒癥患者容1.3.1治療方法兩組均予抗感染、止咳化痰、降壓、降糖、易并發(fā)不同程度的心肌頓抑,發(fā)生率約為50%,其中7%的患糾正水電酸堿平衡紊亂、預(yù)防并發(fā)癥、加強營養(yǎng)支持等對癥治者發(fā)生心力衰竭,并且一旦并發(fā)心肌損傷,病死率將顯著升

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