|本期目录/Table of Contents|

[1]李勇,宋薇.连续性血液净化联合益气活血法对脓毒症伴心肌功能障碍患者的临床疗效观察[J].医学研究与战创伤救治(原医学研究生学报),2018,20(03):225-228.[doi:10.3969/j.issn.1672-271X.2018.03.001]
　LI Yong,SONG Wei.The clinical efficacy of continuous blood purification combined with Yiqi Huoxue for the sepsis patients with myocardial dysfunction[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2018,20(03):225-228.[doi:10.3969/j.issn.1672-271X.2018.03.001]
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连续性血液净化联合益气活血法对脓毒症伴心肌功能障碍患者的临床疗效观察()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第20卷
期数:
2018年03期
页码:
225-228
栏目:
出版日期:
2018-05-09

文章信息/Info

Title:
The clinical efficacy of continuous blood purification combined with Yiqi Huoxue for the sepsis patients with myocardial dysfunction
作者:
李勇; 宋薇
作者单位：730050兰州，兰州军区兰州总医院急诊科（李勇、宋薇）
Author(s):
LI Yong; SONG Wei
(Department of Emergency Medicine, Lanzhou General Hospital of Lanzhou Military Region, PLA, Lanzhou 730050, Gansu, China)
关键词:
连续性血液净化; 益气活血; 脓毒症; 心肌功能障碍
Keywords:
continuous blood purification;  Yiqi Huoxue;  sepsis;  myocardial dysfunction
分类号:
R459.5
DOI:
10.3969/j.issn.1672-271X.2018.03.001
文献标志码:
A
摘要:
目的 观察连续性血液净化（CBP）联合益气活血治疗法对改善脓毒症患者心肌功能的临床效果。方法 收集2016年3月至2017年3月在兰州军区兰州总医院就诊的86名脓毒症伴心肌损伤患者临床资料。随机分为2组，单独进行连续性血液净化组（对照组）43例，男23例，女20例，平均年龄为（51.3±13.8）岁；连续性血液净化联合益气活血中药组（联合组）43例，男21例，女22例，平均年龄为（55.9±11.1）岁。治疗前及治疗不同后分别检测并比较2组患者急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)评分、心肌损伤相关生化指标[超敏C-反应蛋白（hsCRP）、心肌肌钙蛋白T(cTnT)、B型利钠肽原N端（NT-proBNT）]和血流动力学指标[心率（HR）、动脉压（MAP）、射血分数（EF）和心指数（CI）]，收集数据并进行统计学分析。结果 ①与治疗前比较，2组患者治疗5d后APACHEⅡ评分均显著降低（P<001）；与对照组比较，联合组治疗5d后APACHEⅡ评分显著降低[(14.61±3.09)分 vs (15.94±3.53)分，P<001]; ②与治疗前比较，2组患者治疗后血浆hsCRP、cTnI和NT-proBNP含量均显著降低（P<001）；与对照组比较，联合组治疗后hsCRP[(1.71±087)mg/L vs (2.15±1.10)mg/L]、cTnI[(014±008)μg/L vs (019±012)μg/L]及NT-proBNP[(105.71±21.64)pg/L vs (118.46±21.40)pg/L]均显著降低（P<005）；③与治疗前比较，2组患者治疗后HR、MAP、EF和CI指标均明显增加（P<001）；与对照组比较，联合组治疗后HR[(10027±14.58)次/min vs (94.00±14.26)次/min]、MAP[(77.93±6.06)mmHg vs (71.73±7.06)mmHg]、EF[(51.58±5.53)% mL/min vs (46.86±3.55)% mL/min]和CI[(2.51±056)L/（min·m2） vs (2.23±058)L/（min·m2）]均显著增加（P<005）。 结论 连续性血液净化联合益气活血法相比单一的血液净化法对脓毒症伴心肌功能障碍患者的疗效显著。
Abstract:
Objective To observe the clinical effect of continuous blood purification combined with Yiqi Huoxue method treated on sepsis with myocardial dysfunction.Methods The clinical data of 86 patients with sepsis and myocardial dysfunction were collected in Lanzhou General Hospital of Lanzhou Military Region from March 2016 to March 2017 and divided into two groups randomly. There were 43 patients in continuous blood purification group (control group), man 23 and women 20, the mean age was (51.3±13.8) years old. The other group use continuous blood purification combined with Yiqi Huoxue method (combined group), man 21 and women 22, the mean age was (55.9±11.1) years old. Before and after the treatment, the APACHE Ⅱ score, biochemical markers of myocardial injury (hsCRP, cTnI and NT-proBNP) and hemodynamic indexes (HR, MAP, EF and CI) were recorded. Data were processed with statistical analysis. Results ①After 5d treatment, the APACHEⅡ score of 2 groups were lower than before (P<0.01). Compared to the control group, the score of combined group decreased significantly [(14.61±3.09) vs (15.94±3.53), P＜0.01].②The level of hsCRP, cTnI and NT-proBNP in two groups dramatically reduced after treated (P＜0.01). Compared to the control group, the reduction of hsCRP, cTnI and NT-proBNP in combined group were more significant [(1.71±0.87)mg/L vs (2.15±1.10)mg/L, (0.14±0.08)μg/L vs (0.19±0.12)μg/L, (105.71±21.64)pg/L vs (118.46±21.40)pg/L, P<0.05]. ③The result of hemodynamic indexes showed that the level of HR, MAP, EF and CI in control and combined group after treatment were higher than before (P<0.01), and compared to the control group, after treatment the level of HR, MAP,EF and CI in combined group increased significantly [(100.27±14.58)/min vs (94.00±14.26)/min, (77.93±6.06)mmHg vs (71.73±7.06)mmHg, (51.58±5.53)%mL/min vs (46.86±3.55)% mL/min, (2.51±0.56) L/(min·m2) vs (2.23±0.58) L/(min·m2), P<0.05].Conclusion The clinical effect of continuous blood purification combined with Yiqi Huoxue in sepsis with myocardial dysfunction was better than use continuous blood purification only.

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备注/Memo

备注/Memo:
基金项目：甘肃省自然科学基金（1308RJZA154）
更新日期/Last Update: 2018-05-20