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目的:观察参附注射液对心搏骤停患者在心肺复苏早期的心肌保护作用,并探讨其作用机制。方法:将32例心搏骤停患者随机分成两组,除常规进行体外心肺复苏及给予复苏药物治疗外,治疗组在复苏开始后即应用参附注射液静脉注射,对照组仅给予等量的生理盐水。观察两组患者恢复有效自主心跳时间,并监测复苏后的心率,血压情况。同时检测患者复苏即刻、复苏后1、3、24h心肌肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(TnI)、脑利钠肽(BNP)及高敏C反应蛋白(hs-CRP)的水平。结果:①参附注射液治疗组患者恢复有效自主心跳的时间较对照组明显缩短,血压回升更快;②两组患者心脏恢复灌注后CK-MB、TnI及BNP均呈上升趋势,但治疗组的升高幅度显著低于对照组(P<0.05);③参附注射液治疗显著抑制了心肺复苏后的炎症反应,hs-CRP较对照组明显下降。结论:参附注射液增加了心肺复苏的成功率,减轻复苏后的心肌损伤和心功能障碍。
Objective: To observe the myocardial protective effect of Shenfu injection on cardiac arrest patients in the early stage of cardiopulmonary resuscitation and to explore its mechanism. Methods: Thirty-two patients with cardiac arrest were randomly divided into two groups. Except routine cardiopulmonary resuscitation and drug treatment of resuscitation, the treatment group received Shenfu injection intravenously after resuscitation, and the control group received only the same amount of Physiological saline. The effective time of spontaneous heartbeat recovery was observed in both groups, and the heart rate and blood pressure after resuscitation were monitored. At the same time, the levels of CK-MB, TnI, BNP and hs- CRP) levels. Results: ①The time of spontaneous heartbeat recovered in Shenfu injection group was significantly shorter than that in control group, and the blood pressure rose more quickly. ② The CK-MB, TnI and BNP in the two groups were increased after cardiopulmonary resuscitation, (P <0.05); ③Shen Fu injection significantly inhibited the inflammatory response after cardiopulmonary resuscitation, hs-CRP decreased significantly compared with the control group. Conclusion: Shenfu injection increased the success rate of cardiopulmonary resuscitation and relieved myocardial damage and cardiac dysfunction after resuscitation.