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目的探讨左西孟旦对脓毒性休克患者血流动力学及心肌损伤标志物的影响。方法选取周口协和骨科医院2016年1月—2017年6月收治的脓毒性休克患者60例,随机分为对照组和观察组各30例。对照组给予血必净注射液治疗,观察组在其基础上给予左西孟旦治疗,疗程均为7d。比较治疗效果。结果经治疗后两组APACHEⅡ评分、血浆BNP水平、心率(HR)、血乳酸水平均较治疗前降低(P<0.05),平均动脉压(MAP)、中心静脉压(CVP)较治疗前升高,且均优于对照组(P<0.05)。经治疗后观察组人心型脂肪酸结合蛋白(h-FABP)、肌钙蛋白I(TNI)、脑钠肽均较治疗前明显下降(P<0.05),且均优于对照组(P<0.05)。治疗期间均未见严重不良反应。结论在常规治疗基础上结合左西孟旦治疗脓毒性休克疗效显著,能改善血流动力学指标、减轻心肌损伤,增强患者心脏收缩功能,且安全性高。
Objective To investigate the effect of levosimendan on hemodynamics and myocardial injury markers in patients with septic shock. Methods Sixty patients with septic shock who were treated in Zhoukou Union orthopedic hospital from January 2016 to June 2017 were randomly divided into control group and observation group of 30 cases. The control group was treated with Xuebijing Injection, and the observation group was given levosimendan on the basis of treatment. The course of treatment was 7 days. Compare treatment effects. Results APACHEⅡscore, plasma BNP level, heart rate (HR) and blood lactic acid level decreased after treatment in both groups (P <0.05), mean arterial pressure (MAP) and central venous pressure , Both of which were better than the control group (P <0.05). After treatment, the levels of h-FABP, TNI and BNP in observation group were significantly lower than those before treatment (P <0.05), and both were better than those in control group (P <0.05) . No serious adverse reactions were observed during the treatment. Conclusion The treatment of septic shock combined with levosimendan on the basis of conventional treatment has significant curative effect, which can improve hemodynamic indexes, reduce myocardial injury, enhance cardiac systolic function and have high safety.