中国医药指南
中國醫藥指南
중국의약지남
CHINA MEDICINE GUIDE
2013年
31期
299-299,301
,共2页
孟繁甦%郭应军%黄小洵%陈君千
孟繁甦%郭應軍%黃小洵%陳君韆
맹번소%곽응군%황소순%진군천
左西孟旦%脓毒症休克%心功能%临床疗效
左西孟旦%膿毒癥休剋%心功能%臨床療效
좌서맹단%농독증휴극%심공능%림상료효
Levosimendan%Septic shock%Heart function%Clinical effect
目的:观察左西孟旦对脓毒症休克患者心功能的影响。方法病例来源于2011年8月至2013年2月我院重症医学科的脓毒症休克患者,经过筛选后共有合格病例46例,其中对照组22例,试验组24例。两组均按照脓毒症治疗指南治疗,必要时使用升压药物,使MAP≥75mmHg。对照组采用多巴酚丁胺针5μg/(min?kg),连续24h用药,最大使用量不超过40μg/(min?kg)。试验组给予左西孟旦针(5%葡萄糖45mL+左西孟旦针12.5mg),12mL/h泵入10min,后以2mL/h静脉注射,持续24h。入组当天和第6天晨检测血肌钙蛋白、脑肭肽及PCT含量,行床边心脏超声评估心功能。计算各组治疗前后APACHEⅡ评分。记录ICU内全因病死率。结果两组患者治疗前心室射血分数(LVEF)、心脏指数(CI)无显著性差异(P>0.05),治疗后两组患者的CI和LVEF均有升高,肺动脉平均压(PAMP)则下降,以试验组治疗后比对照组同期改善明显(P<0.05)。两组患者治疗前的肌钙蛋白、脑钠肽无显著性差异(P>0.05),治疗后两组肌钙蛋白、脑钠肽均明显下降,以试验组下降明显(P<0.05)。治疗前及治疗后的降钙素原和APACHEⅡ组间比较无显著性差异(P>0.05)。两组的ICU内全因病死率比较无差异(P>0.05)。结论左西孟旦针能改善脓毒症休克患者心功能。
目的:觀察左西孟旦對膿毒癥休剋患者心功能的影響。方法病例來源于2011年8月至2013年2月我院重癥醫學科的膿毒癥休剋患者,經過篩選後共有閤格病例46例,其中對照組22例,試驗組24例。兩組均按照膿毒癥治療指南治療,必要時使用升壓藥物,使MAP≥75mmHg。對照組採用多巴酚丁胺針5μg/(min?kg),連續24h用藥,最大使用量不超過40μg/(min?kg)。試驗組給予左西孟旦針(5%葡萄糖45mL+左西孟旦針12.5mg),12mL/h泵入10min,後以2mL/h靜脈註射,持續24h。入組噹天和第6天晨檢測血肌鈣蛋白、腦肭肽及PCT含量,行床邊心髒超聲評估心功能。計算各組治療前後APACHEⅡ評分。記錄ICU內全因病死率。結果兩組患者治療前心室射血分數(LVEF)、心髒指數(CI)無顯著性差異(P>0.05),治療後兩組患者的CI和LVEF均有升高,肺動脈平均壓(PAMP)則下降,以試驗組治療後比對照組同期改善明顯(P<0.05)。兩組患者治療前的肌鈣蛋白、腦鈉肽無顯著性差異(P>0.05),治療後兩組肌鈣蛋白、腦鈉肽均明顯下降,以試驗組下降明顯(P<0.05)。治療前及治療後的降鈣素原和APACHEⅡ組間比較無顯著性差異(P>0.05)。兩組的ICU內全因病死率比較無差異(P>0.05)。結論左西孟旦針能改善膿毒癥休剋患者心功能。
목적:관찰좌서맹단대농독증휴극환자심공능적영향。방법병례래원우2011년8월지2013년2월아원중증의학과적농독증휴극환자,경과사선후공유합격병례46례,기중대조조22례,시험조24례。량조균안조농독증치료지남치료,필요시사용승압약물,사MAP≥75mmHg。대조조채용다파분정알침5μg/(min?kg),련속24h용약,최대사용량불초과40μg/(min?kg)。시험조급여좌서맹단침(5%포도당45mL+좌서맹단침12.5mg),12mL/h빙입10min,후이2mL/h정맥주사,지속24h。입조당천화제6천신검측혈기개단백、뇌눌태급PCT함량,행상변심장초성평고심공능。계산각조치료전후APACHEⅡ평분。기록ICU내전인병사솔。결과량조환자치료전심실사혈분수(LVEF)、심장지수(CI)무현저성차이(P>0.05),치료후량조환자적CI화LVEF균유승고,폐동맥평균압(PAMP)칙하강,이시험조치료후비대조조동기개선명현(P<0.05)。량조환자치료전적기개단백、뇌납태무현저성차이(P>0.05),치료후량조기개단백、뇌납태균명현하강,이시험조하강명현(P<0.05)。치료전급치료후적강개소원화APACHEⅡ조간비교무현저성차이(P>0.05)。량조적ICU내전인병사솔비교무차이(P>0.05)。결론좌서맹단침능개선농독증휴극환자심공능。
Objective Analyze the Cardiovascular effect of levosimendan on sepsis shock. patients. Methods 46 cases of sepsis shock patients admitted to the ICU department during 2011.8~2013.2 were included, they were randomly divided into control group (n=22) and treatment group (n=24). The treatment group was received regular treatments plus levosimendan. The content of troponin, BNP and PCT were monitored on1 and 6 day. LVEF、CI and PAMP were evaluated through cardiac ultrasound at different points. Results Two groups of patients before treatment ventricular ejection fraction (LVEF), cardiac index (CI) was no signiifcant difference (P>0.05), After treatment of the CI and LVEF had increased mean pulmonary artery pressure (PAMP) decreased in the experimental group than the control group after treatment period improved signiifcantly (P<0.05). Two groups of patients before treatment troponin, brain natriuretic peptide was no signiifcant difference (P>0.05), After treatment troponin, brain natriuretic peptide were signiifcantly decreased in the experimental group decreased signiifcantly (P<0.05). Before treatment and after treatment procalcitonin and APACH E Ⅱgroups showed no signiifcant difference (P>0.05). Two sets of all-cause mortality in ICU was no signiifcant difference (P>0.05).Conclusion Levosimendan needle can improve heart function in patients with septic shock.