【摘要】：目的:探討膿毒癥休克患者分別應用左西孟旦(LEV)與多巴酚丁胺(Dob)對心肌抑制的改善效果。方法:選取我院2014年7月~2016年6月收治的63例膿毒癥休克患者,依照隨機數(shù)字表法分為觀察組(31例)和對照組(32例)。兩組均給予常規(guī)基礎治療,在其基礎上,對照組予以Dob治療,觀察組給予LEV治療。記錄比較兩組治療前后左室收縮期末容積指數(shù)(LVESI)、左室舒張期末容積指數(shù)(LVEDI)及左心射血分數(shù)(LVEF)、心肌肌鈣蛋白I(cTnI)、腦鈉肽(BNP)及急性生理學與慢性健康狀況評分系統(tǒng)Ⅱ(APACHEⅡ)評分,預后情況。結果:與治療前比較,兩組治療7 d時LVESI、LVEDI、LVEF,均顯著改善(P0.01);且觀察組改善程度較對照組相比,更為顯著(P0.01);兩組治療7d時血清cTnI、BNP水平和APACHEⅡ評分,均顯著低于治療前(P0.01);與對照組治療7d時相比,觀察組心肌損傷指標及APACHEⅡ評分改善程度均更為顯著(P0.01);觀察組28d生存率為54.8%略高于對照組的50.0%,但組間差異無統(tǒng)計學意義(P0.05)。結論:膿毒癥休克患者應用LEV更有利于提高心臟功能,穩(wěn)定病情,改善心肌抑制,具有較高臨床推廣價值。
[Abstract]:Aim: to investigate the effects of levsimendan (LEV) and dobutamine (Dob) on myocardial inhibition in septic shock patients. Methods: 63 patients with septic shock from July 2014 to June 2016 were randomly divided into observation group (n = 31) and control group (n = 32). On the basis of routine basic therapy, the control group was treated with Dob and the observation group with LEV. Left ventricular end-systolic volume index (LVESI),) and left ventricular end-diastolic volume index (LVEDI) and left ventricular ejection fraction (LVEF),) cardiac troponin I (cTnI), were recorded and compared between the two groups before and after treatment. Brain natriuretic peptide (BNP), acute physiology and chronic health status scoring system 鈪，

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