Effect of Shenmai injection with hemoperfusion in treatment of myocardial depression in septic shock
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摘要: 目的 研究参麦注射液联合血液灌流对脓毒症休克各种主要心肌抑制因子及心功能的影响。 方法 选择2015年1月-2016年8月绍兴市人民医院重症医学科收治的60例脓毒症休克患者,按随机数字表法随机分为对照组、参麦组、参麦联合血液灌流组(联合组),每组20例。对照组:在脓毒症标准治疗基础上未加任何干预措施,参麦组:对照组基础上加参麦注射液,联合组:参麦组基础上加用HA330血液灌流。观察治疗前及治疗后第7天的APACHE Ⅱ评分、心脏指数(CI)、血浆B型脑钠肽(BNP)、高迁移率族蛋白B-1(HMGB-1)、白三烯(LT)、内皮素-1(ET-1)。 结果 治疗前,各组患者APACHEⅡ评分、CI、BNP、HMBG-1、LT、ET-1比较,差异均无统计学意义(均P>0.05)。治疗后第7天,对照组、参麦组、联合组APACHEⅡ评分、BNP、HMBG-1、LT、ET-1均较同组治疗前下降,CI均较同组治疗前升高,差异均有统计学意义(均P<0.05)。参麦组、联合组APACHEⅡ评分、BNP、HMBG-1、LT、ET-1水平较对照组低,CI水平较对照组高,差异均有统计学意义(均P<0.05);联合组APACHEⅡ评分、BNP、HMBG-1、LT、ET-1水平又较参麦组低,CI水平较参麦组高,差异均有统计学意义(均P<0.05)。与对照组比较,联合组28天生存率明显增加,差异有统计学意义(P<0.05)。 结论 在脓毒症休克标准治疗基础上加用参麦注射液与血液灌流,有效地降低了循环中心肌抑制因子水平,增加心肌收缩能力,改善患者的心功能和28天生存率。Abstract: Objective To investigate the effect of Shenmai injection with hemoperfusion on myocardial depressant factor(MDF) and cardiac function in septic shock. Methods In this study, 60 patients with septic shock in our Department were randomly divided into 3 groups with 20 cases in each group:the control group, the Shenmai injection group and the Shenmai injection with hemoperfusion group. All the patients received regular therapy. The patients in the Shenmai injection group were treated with Shenmai injection on the basis of the control group. The patients in the Shenmai injection with hemoperfusion group were treated with hemoperfusion(HA330) on the basis of the Shenmai injection group. The levels of APACHEⅡ score, cardiac index(CI), brain natriuretic peptide(BNP), high mobility group protein B1(HMGB-1), leukotriene(LT) and endothelin1(ET-1) before treatment and after seven days of treatment were observed. Results APACHEⅡ score, CI, BNP, HMGB-1, LT and ET-1 among the three groups were not significantly different from each other before the treatment(P>0.05). Compared with those before the treatment, APACHEⅡ score, BNP, HMGB-1, LT and ET-1 in all the three groups decreased after the treatment, CI increased after the treatment, and it was statistically significant(P<0.05). Compared with the control group and the Shenmai injection group, APACHE Ⅱ score, BNP, HMGB-1, LT and ET-1 in the Shenmai injection group were decreased after treatment, and CI was increased, and it was statistically significant(P<0.05). Compared with the Shenmai injection group and the Shenmai injection with hemoperfusion group, APACHE Ⅱ score, BNP, HMGB-1, LT and ET-1 in the Shenmai injection with hemoperfusion group were decreased after the treatment, and CI was increased, and it was statistically significant(P<0.05). Conclusion Shenmai injection with hemoperfusion can reduce the level of myocardial depressant factors, improve the ability of cardiac function and the survival rate of patients in septic shock.
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Key words:
- Septic Shock /
- Myocardial depressant factor /
- Shenmai injection /
- Hemoperfusion
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