發(fā)布時(shí)間：2018-03-14 12:01

  本文選題：膿毒癥　切入點(diǎn)：心肌損傷　出處：《第二軍醫(yī)大學(xué)學(xué)報(bào)》2017年06期 　論文類(lèi)型：期刊論文

【摘要】：目的探討舒血寧對(duì)嚴(yán)重膿毒癥心肌損傷患者早期心肌損傷指標(biāo)和氧化應(yīng)激水平的影響。方法選擇我院2013年3月至2016年6月收治的符合嚴(yán)重膿毒癥伴心肌損傷患者102例,隨機(jī)分為對(duì)照組和治療組,各51例,對(duì)照組給予常規(guī)治療;治療組在常規(guī)治療基礎(chǔ)上加用舒血寧。記錄兩組患者在治療前(入院時(shí))及治療后(入院后)6h、72hN-末端腦鈉鈦前體(NT-proBNP)、心型脂肪酸結(jié)合蛋白(hFABP)、肌鈣蛋白I(cTnI)、丙二醛(MDA)、超氧化物歧化酶(SOD)及谷胱甘肽過(guò)氧化物酶(GSH-Px)等各指標(biāo)的變化,同時(shí)觀察患者左室射血分?jǐn)?shù)(LVEF)水平、急性生理學(xué)和慢性健康狀況評(píng)分Ⅱ(APACHEⅡ)的變化,以及ICU住院時(shí)間和28d生存情況。結(jié)果治療前兩組患者NTproBNP、hFABP、cTnI、MDA、SOD、GSH-Px各指標(biāo)及APACHEⅡ評(píng)分、LVEF比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。治療后6h,治療組患者NT-proBNP、hFABP、cTnI和MDA水平均低于對(duì)照組,SOD和GSH-Px活性均高于對(duì)照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);兩組患者NT-proBNP、hFABP、cTnI和MDA水平均較組內(nèi)治療前升高,SOD和GSH-Px活性均較組內(nèi)治療前降低(P0.05)。治療后72h,兩組hFABP和MDA水平均較治療后6h降低,NTproBNP、cTnI水平,SOD、GSH-Px活性均較治療后6h升高,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后72h,對(duì)照組NTproBNP、cTnI和MDA水平均高于治療組,SOD和GSH-Px活性均低于治療組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),兩組患者h(yuǎn)FABP水平比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。兩組患者治療后APACHEⅡ評(píng)分均較治療前改善(P0.05),而兩組治療后的LVEF和ICU住院時(shí)間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);治療組患者28d病死率低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論舒血寧對(duì)嚴(yán)重膿毒癥心肌損傷患者的療效優(yōu)于常規(guī)治療,能降低NT-proBNP、hFABP、cTnI、MDA水平和APACHEⅡ評(píng)分,提高SOD和GSH-Px活性,改善患者預(yù)后。
[Abstract]:Objective to investigate the effects of Shuxuening on early myocardial injury index and oxidative stress in patients with severe sepsis. Methods 102 patients with severe sepsis with myocardial injury were selected from March 2013 to June 2016 in our hospital. They were randomly divided into control group and treatment group with 51 cases each. The control group was given routine treatment. The patients in the treatment group were treated with Shuxuening on the basis of routine treatment. Before and after treatment, NT-proBNPP, cardiac fatty acid binding protein, cardiac fatty acid binding protein, malondialdehyde (MDA), malondialdehyde (MDA) MDAA, NT-proBNPP, cardiac fatty acid binding protein, malondialdehyde (malondialdehyde) MDAA were recorded before and after treatment in both groups. The changes of chemical dismutase (SOD) and glutathione peroxidase (GSH-Px), At the same time, the changes of left ventricular ejection fraction (LVEFX), acute physiology and chronic health status 鈪，

本文編號(hào)：1611117