参麦注射液联合左西孟旦治疗脓毒症疗效观察
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摘要
目的研究参麦注射液联合左西孟旦对脓毒症患者治疗效果。方法选取本院2016年4月-2018年4月收治的脓毒症患者142例为研究对象,按照随机数表法分为联用组和对照组,每组71例。对照组在常规干预的基础上给予左西孟旦静脉注射治疗,联用组在对照组的基础上给予参麦注射液联合处理。治疗前后分别对两组患者血清白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、血管紧张素转化酶(ACE)水平、左室短轴缩短率(FS)、左室射血分数(LVEF)及急性生理与慢性健康评分(APACHEⅡ)、全身性感染相关器官衰竭评分(SOFA)进行收集,评估疾病进程及心肺等功能。结果联用组患者治疗后血清IL-6、IL-8、IL-10、TNF-α水平分别为(30.65±5.92)pg/mL、(14.73±2.85)pg/mL、(13.98±2.06)pg/mL、(12.47±2.18)pg/mL,显著低于对照组的(52.38±10.43)pg/mL、(26.34±5.51)pg/mL、(15.45±2.22)pg/mL、(19.00±3.73)pg/mL,差异有统计学意义(P<0.05);联用组患者治疗后FS、LVEF水平分别为(40.68±7.95)%、(55.27±11.36)%,显著高于对照组的(29.26±5.82)%、(43.20±8.14)%,差异有统计学意义(P<0.05);联用组治疗后ACE水平为(37.67±6.93)U/L,显著低于对照组(46.32±8.81)U/L,差异有统计学意义(P<0.05);联用组患者治疗后APACHEⅡ评分及SOFA评分分别为(13.71±2.42)分、(0.87±0.16)分,显著低于对照组的(18.35±3.61)分、(3.59±0.75)分,差异有统计学意义(P<0.05)。结论参麦注射液联合左西孟旦可有效控制脓毒症患者疾病进程,改善心肺功能,缓解器官功能障碍,提高治疗效果。
Objective To study the therapeutic effect of Shenmai injection combined with levosimendan on sepsis patients.Methods 142 patients with sepsis admitted to our hospital from April 2016 to April 2018 were selected as the study subjects;they were divided into combined group and control group according to random number table method,with 71 cases in each group. The control group was treated with Levosimendan intravenous injection on the basis of routine intervention,and the combined group was treated with Shenmai Injection on the basis of the control group. Serum interleukin-6(IL-6),interleukin-8(IL-8),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α),angiotensin converting enzyme(ACE)level,fractional shortening(FS),leftventricularejectionfraction(LVEF),AcutePhysiologyAndChronicHealthScore(APACHEⅡ),SepsisRelated Organ Failure Assessment score(SOFA)were collected before and after treatment,assessment of disease progression and cardiopulmonary function. Results Serum levels of IL-6,IL-8,IL-10,TNF-α in the combined group after treatment were(30.65±5.92)pg/mL,(14.73±2.85)pg/mL,(13.98±2.06)pg/mL and(12.47±2.18)pg/mL,respectively,significantly lower than those in the control group[(52.38±10.43)pg/mL,(26.34±5.51)pg/mL,(15.45±2.22)pg/mL and(19.00±3.73)pg/mL],respectively(P<0.05). The levels of FS and LVEF in the combined group after treatment were(40.68±7.95)% and(55.27±11.36)%,respectively,significantly higher than those in the control group(29.26±5.82)% and(43.20±8.14)%,respectively(P<0.05). ACE level in the combined group after treatment was(37.67±6.93)U/L,which was significantly lower than that in the control group(46.32±8.81) U/L(P<0.05). APACHE Ⅱ score and SOFA score in the combined group after treatment were(13.71±2.42)and(0.87±0.16),respectively,which were significantly lower than those in the control group(18.35±3.61)and(3.59±0.75),respectively(P<0.05). Conclusion Shenmai Injection combined with Levosimendan could effectively control the course of sepsis,improve cardiopulmonary function,alleviate organ dysfunction,and improve therapeutic effect.
Objective To study the therapeutic effect of Shenmai injection combined with levosimendan on sepsis patients.Methods 142 patients with sepsis admitted to our hospital from April 2016 to April 2018 were selected as the study subjects;they were divided into combined group and control group according to random number table method,with 71 cases in each group. The control group was treated with Levosimendan intravenous injection on the basis of routine intervention,and the combined group was treated with Shenmai Injection on the basis of the control group. Serum interleukin-6(IL-6),interleukin-8(IL-8),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α),angiotensin converting enzyme(ACE)level,fractional shortening(FS),leftventricularejectionfraction(LVEF),AcutePhysiologyAndChronicHealthScore(APACHEⅡ),SepsisRelated Organ Failure Assessment score(SOFA)were collected before and after treatment,assessment of disease progression and cardiopulmonary function. Results Serum levels of IL-6,IL-8,IL-10,TNF-α in the combined group after treatment were(30.65±5.92)pg/mL,(14.73±2.85)pg/mL,(13.98±2.06)pg/mL and(12.47±2.18)pg/mL,respectively,significantly lower than those in the control group[(52.38±10.43)pg/mL,(26.34±5.51)pg/mL,(15.45±2.22)pg/mL and(19.00±3.73)pg/mL],respectively(P<0.05). The levels of FS and LVEF in the combined group after treatment were(40.68±7.95)% and(55.27±11.36)%,respectively,significantly higher than those in the control group(29.26±5.82)% and(43.20±8.14)%,respectively(P<0.05). ACE level in the combined group after treatment was(37.67±6.93)U/L,which was significantly lower than that in the control group(46.32±8.81) U/L(P<0.05). APACHE Ⅱ score and SOFA score in the combined group after treatment were(13.71±2.42)and(0.87±0.16),respectively,which were significantly lower than those in the control group(18.35±3.61)and(3.59±0.75),respectively(P<0.05). Conclusion Shenmai Injection combined with Levosimendan could effectively control the course of sepsis,improve cardiopulmonary function,alleviate organ dysfunction,and improve therapeutic effect.
引文
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[9]杨江江.小剂量左西孟旦联合盐酸多巴酚丁胺治疗老年脓毒症并发急性左心衰竭效果观察[J].中国乡村医药,2016,23(16):26-27,29.
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[12]陈中腾,张远怀,崔可,等.中医辨证治疗脓毒症的临床疗效[J].中华中医药学刊,2018,36(3):726-728.
[13]孟冬梅,邵金莲,张映喜.血中各项炎症因子在脓毒症中的诊断价值[J].广东医学,2017,38(5):753-755.
[14]王丽娜,王华成,张一彤,等.血清IL-6对脓毒症病情判断的作用[J].中国热带医学,2018,18(8):827-829.
[15]朱飞宇,石学银.早期脓毒症生物分子预警的研究进展[J].国际麻醉学与复苏杂志,2016,37(2):169-174.
[2]盛博,陈炜,甄洁,等.入院时APACHEⅡ评分、SOFA评分及ALB水平对严重脓毒症患者预后结局的影响[J].热带医学杂志,2017,17(12):1648-1651,1708.
[3]姚咏明,盛志勇,林洪远,等. 2001年国际脓毒症定义会议关于脓毒症诊断的新标准[J].中华危重病急救医学,2006,18(11):645-646.
[4]中国中西医结合学会急救医学专业委员会,《中国中西医结合急救杂志》编辑委员会.脓毒症中西医结合诊治专家共识[J].中华危重病急救医学,2013,25(4):194-197.
[5]杨霞,李香琴,马晓媛,等.脓毒症血管内皮损伤及调节策略的研究进展[J].中国中西医结合急救杂志,2016,23(1):108-110.
[6]姚咏明,张艳敏.脓毒症发病机制最新认识[J].医学研究生学报,2017,30(7):678-683.
[7]刘力名,彭锦,乔鲁军,等.左西孟旦用于严重脓毒血症和脓毒性休克并发心力衰竭患者的Meta分析[J].中华医院感染学杂志,2017,27(24):5549-5553.
[8]徐彩霞,李莉,严静.左西孟旦治疗脓毒性休克的研究进展[J].中国中西医结合急救杂志,2017,24(6):669-672.
[9]杨江江.小剂量左西孟旦联合盐酸多巴酚丁胺治疗老年脓毒症并发急性左心衰竭效果观察[J].中国乡村医药,2016,23(16):26-27,29.
[10]赵国桢,郭玉红,李博,等.中医药防治脓毒症的研究进展[J].中国中药杂志,2017,42(8):1423-1429.
[11]袁晓雯,姜楠,陈冰,等.中医方剂治疗脓毒症的研究进展[J].中国中医基础医学杂志,2017,23(2):292-296.
[12]陈中腾,张远怀,崔可,等.中医辨证治疗脓毒症的临床疗效[J].中华中医药学刊,2018,36(3):726-728.
[13]孟冬梅,邵金莲,张映喜.血中各项炎症因子在脓毒症中的诊断价值[J].广东医学,2017,38(5):753-755.
[14]王丽娜,王华成,张一彤,等.血清IL-6对脓毒症病情判断的作用[J].中国热带医学,2018,18(8):827-829.
[15]朱飞宇,石学银.早期脓毒症生物分子预警的研究进展[J].国际麻醉学与复苏杂志,2016,37(2):169-174.