左西孟旦治疗脓毒性休克患者临床效果观察及对血流动力学水平的影响

摘要

Objective To observe the therapeutic effects of levosimendan on septic shock and its effects on hemodynamics in patients with septic shock.Methods Seventy-four patients with septic shock who were admitted and treated in our hospital from June 2014 to June 2008 were randomly divided into the observation group and the control group,with 37 patients in each group.The patients in control group were treated with Xuebijing injection,however,the patients in observation group,on the basis of control group,were treated by levosimendan,with a treatment course of 7 days for both groups.The APACHE Ⅱ score,plasma BNP,HR,MAP,myocardial enzyme indexes and incidence rates of adverse reactions were observed and compared between two groups before and after treatment.Results After treatment the APACHE Ⅱ score and plasma levels of BNP were significantly decreased in both groups (P<0.05),moreover,the APACHE Ⅱ score and plasma levels of BNP in observation group were obviously lower than those in control group (P<0.05).After treatment HR was decreased,however,MAP was increased in both groups (P<0.05),moreover,HR in observation group was obviously lower than that in control group,but MAP was significantly higher than that in control group (P<0.05).The levels of LDH,CK-MB and cTnI were significantly decreased after treatment (P<0.05),furthermore,the levels of LDH,CK-MB,cTnI in observation group were obviously lower than those in control group (P<0.05).Besides no severe adverse reactions were found in both groups.Conclusion The therapeutic effects of levosimendan on septic shock are quite significant,which can improve hemodynamics of patients with septic shock,with good safety,therefor,which is worth researching further.%目的 探讨左西孟旦治疗脓毒性休克患者临床效果及对患者血流动力学水平的影响.方法 选择2014年6月至2016年6月收治的脓毒性休克患者74例,按照随机数字表法随机分为观察组与对照组,每组37例.对照组给予血必净注射液治疗,观察组在对照组基础上结合左西孟旦治疗.2组疗程均为7 d.比较2组患者治疗前后APACHE Ⅱ评分、血浆BNP、HR、MAP、心肌酶指标变化,及不良反应发生情况.结果 2组APACHE II评分和血浆BNP治疗后降低(P<0.05);观察组APACHE Ⅱ评分和血浆BNP治疗后低于对照组(P<0.05);2组HR治疗后降低,MAP治疗后增加(P<0.05);观察组HR治疗后低于对照组,MAP治疗后高于对照组(P<0.05);2组LDH、CK-MB、cTnI治疗后降低(P<0.05);观察组LDH、CK-MB、cTnI治疗后低于对照组(P<0.05);2组均未见严重不良反应.结论 左西孟旦治疗脓毒性休克患者临床效果显著,可改善患者血流动力学,且用药安全性良好,值得研究.