目的 评价参附注射液加血必净注射液对(脓毒症心肌病SIC)患者循环和毛细血管充盈时间的影响。方法 将87例SIC患者随机分为治疗组和对照组,对照组44例,治疗组43例。对照组患者给予脓毒症集束化治疗;治疗组在对照组的基础上给予血必净注射液加参附注射液静脉滴注,两组疗程均为3 d。评估病情和预后指标(APACHE Ⅱ评分、SOFA评分)、心肌损伤标志物(cTnT、NT-ProBNP)、血流动力学指标(MAP、CVP、CI)、微循环指标(Lac、24 h Lac清除率、CRT)。结果 治疗后,两组APACHE Ⅱ评分、SOFA评分、cTnT、NT-ProBNP、Lac、CRT均降低(P<0。05),均以治疗组更明显(P<0。05),24 h Lac清除率治疗组高于对照组(P<0。05)。治疗后两组患者MAP、CVP较治疗前均升高,治疗后24、48、72 h,治疗组CI高于照组;治疗后第6、24 h,治疗组患者Lac低于对照组(P<0。05);治疗后第3、6、24 h,治疗组患者CRT低于对照组(P<0。05)。结论 在西医常规集束化治疗的基础上,加用参附注射液和血必净注射液治疗,可改善微循环及血流动力学,抑制心肌损伤,有利于改善SIC患者的心功能。
Effects of Shenfu Injection combined with Xuebijing Injection on circulation and capillary filling time in patients with sepsis-induced cardiomyopathy
Objective Evaluate the effects of Shenfu Injection and Xuebijing Injection on circulation and capil-lary filling time in sepsis-induced cardiomyopathy(SIC)patients.Methods 87 SIC patients were randomly divid-ed into the treatment group and control group,with 44 cases in the control group and 43 cases in the treatment group.The control group patients were treated with bundle therapy for sepsis;The treatment group received in-travenous infusion of Xuebijing Injection and Shenfu Injection on the basis of bundle therapy,and both groups had a treatment period of 3 days.Evaluate the condition and prognostic indicators(APACHE Ⅱ score,SOFA score),myocardial injury markers(cTnT,NT-ProBNP),hemodynamic indicators(MAP,CVP,CI),microcir-culation indicators(Lac,24-hour Lac clearance rate,CRT).Results After treatment,the APACHE Ⅱ score,SOFA score,cTnT,NT-ProBNP,Lac,and CRT in both groups decreased(P<0.05),with the treatment group showing a more significant decrease(P<0.05).The 24-hour Lac clearance rate in the treatment group was higher than that in the control group(P<0.05).After treatment,the MAP and CVP of both groups of patients increased compared to before treatment.At 24,48,and 72 h after treatment,the CI of the treatment group was higher than that of the control group.At 6 and 24 h after treatment,the Lac in the treatment group was lower than that in the control group(P<0.05),and at 3,6,and 24 h after treatment,the CRT in the treatment group was lower than that in the control group(P<0.05).Conclusion On the basis of conventional bundle ther-apy in Western medicine,the addition of Shenfu Injection and Xuebijing Injection can improve microcirculation and hemodynamics,inhibit myocardial injury,and be beneficial for improving heart function of SIC patients.