摘要
目的:观察盐酸纳美芬辅助治疗脓毒性休克患者心肌损伤的临床效果。方法:脓毒性休克患者78例随机分为观察组40例和对照组38例。两组患者入院后均按指南推荐的早期目标导向治疗(EDGT)集束化治疗方案指导复苏。观察组在此基础上连续24 h静脉注射盐酸纳美芬注射液。研究终点为24 h内患者死亡或退出研究。检测两组患者入院1,6,12,24 h时N-末端原脑利钠肽(NT-proBNP)、肌钙蛋白Ⅰ(c TnⅠ)、肌酸激酶同工酶(CK-MB)和肌酸激酶(CK)水平。结果:治疗12 h时,两组患者的NT-proBNP水平较前显著降低(P<0.05);观察组CK和CK-MB水平较前显著降低(P<0.05);治疗24 h时,两组的c TnⅠ、CK和CK-MB水平较前显著降低(P<0.05)。观察组治疗12,24 h时的c TnⅠ、CK和CK-MB水平均明显低于对照组(P<0.05)。结论:给予脓毒性休克患者盐酸纳美芬干预治疗,可明显改善血清NT-proBNP、c TnⅠ、CK-MB和CK水平,减轻心肌损伤程度。
Objective: To investigate the clinical effect of nalmefene hydrochloride in the treatment of myocardial injury in patients with septic shock. Methods: A total of 78 patients with septic shock admitted to the emergency department of the Department of Critical Care Medicine in our hospital in February 2018 were selected as the study subjects. The observation group and the control group were divided according to the random number table method,and 40 in the observation group and 38 in the control group. Both groups were guided to obtain resuscitation after the admission according to the early goal-directed therapy( EDGT) clustering regimen recommended by the guidelines. Furthermore,the patients in the observation group were given intravenous injection of nalmefene hydrochloride for 24 hours. NT-proBNP,troponin I( cTn I),creatine kinase isoenzyme( CK-MB) and creatine kinase( CK) levels were measured at 1 h,6 h,12 h and 24 h after the admission. The end point of the study was death or withdrawal from the study within 24 hours. Results: At 12 h after the treatment,the levels of NT-proBNP were significantly lower in the two groups( P < 0. 05). The levels of CK and CK-MB in the observation group were significantly lower than those before the treatment( P < 0. 05). At 24 h,the levels of c Tnl,CK and CK-MB in the two groups were significantly lower than those before the treatment( P < 0. 05). The levels of c Tnl,CK and CK-MB in the observation group at 12 and 24 h were significantly lower than those in the control group( P < 0. 05). Conclusion:The intervention of nalmefene hydrochloride in patients with septic shock can significantly improve the levels of serum NT-proBNP,c Tn I,CK-MB and CK,and reduce the degree of myocardial injury. It provides a better experimental data support for the improvement of septic shock prognosis with nalmefene in the combination with conventional treatment regimen.
作者
黄敏
邱光钰
Huang Min;Qiu Guangyu(Department of Critical Care Medicine,Xiangyang Central Hospital, Affiliated Hospital of Hubei Universityof Arts and Science, Hubei Xiangyang 441021, China)
出处
《中国药师》
CAS
2019年第10期1874-1876,共3页
China Pharmacist
关键词
纳美芬
脓毒症
休克
心肌损伤
Nalmefene
Sepsis
Shock
Myocardial injury
