连续血液净化对重症脓毒症休克并心肌损伤患者的影响

摘要

Objective:To explore the effect of severe sepstic patients with shock and myocardial damage treated by continuous blood purification (CBP). Methods: 60 severe septic patients with shock and myocardial damage were randomly divided into control group (n = 31) and CBP group (n = 29).CK-MB,BNP,cTnI,LAC,P (A-a)O2, APACHE Ⅱ score,CO,MAP, HR and were 28 d mortality were compared between the two groups.Results:Compared with the control group,CK-MB, BNP, cTnI, LAC, P(A-a)O2, APACHE Ⅱ score, HR and the mortality of 28 d significantly decreased (all P < 0.05),while MAP increased in CBP group (P < 0.05). Conclusion:Early CBP treatment can protect severe sepstic patients with shock and myocardial damage and improve the prognosis.%目的：探讨连续血液净化（CBP）对重症脓毒症休克伴心肌损伤患者的影响。方法：将60例重症脓毒症休克并心肌损伤患者随机分为对照组（n＝31）和CBP组（n＝29），比较两组治疗前及治疗48 h 时肌酸激酶同工酶（CK－MB）、脑尿钠肽（BNP）、肌钙蛋白（cTnI）、动脉血乳酸（LAC）、肺泡动脉氧分压差[P（A－a）O2]、APACHEⅡ评分、心输出量（CO）、平均动脉压（MAP）、心率（HR）及28 d 病死率。结果：与对照组相比，CBP 组 CK－MB、BNP、cTnI、LAC、P（A－a）O2、APACHEⅡ评分明显降低、MAP 升高，心动过速明显纠正，28 d 病死率明显降低。结论：血液净化对重症脓毒症休克患者并心肌损伤具有保护作用，可改善患者预后。