中药联合艾司洛尔对脓毒症患者心肌抑制的干预效果分析

目的探讨中药联合β受体阻滞剂艾司洛尔对脓毒症患者心肌抑制的干预效果。方法将2014年1月~2017年1月符合脓毒症诊断的患者106例,采用随机数字表法分为中药联合艾司洛尔组(53例)和对照组(53例)。对照组按照脓毒症休克指南常规治疗,并给与艾司洛尔干预;中药联合艾司洛尔组在对照组的基础上,给予中药参松养心胶囊治疗。两组均治疗1周后,分别测定治疗前和治疗后患者血清心肌肌钙蛋白Ⅰ(cTnⅠ)浓度,并通过超声心动图随访评价两组患者治疗后心功能,比较主要心血管事件(MACE)的发生情况。结果中药联合艾司洛尔组治疗后cTnⅠ水平明显低于对照组(P0.05),而且治疗后cTnI0.10μg/L患者的比例明显低于对照组(P0.01)。随访1个月后,中药联合艾司洛尔组患者左心室收缩末内径低于对照组(P0.05),左心室射血分数高于对照组(P0.01);两组MACE发生率比较,差异无统计学意义。结论中药联合艾司洛尔组可以减少心肌抑制,提高心肌功能,治疗后长期服用可以改善患者的左心室功能。

Effect of traditional Chinese medicine combined with esmolol on myocardial depression in patients with sepsis

Objective To investigate the effect of escitalopine,a β-blocker,on myocardial inhibition in sepsis patients.Methods 106 patients with sepsis were enrolled from January 2014 to January 2017.Patients were divided into chinese medicine combined with esmolol (53 cases) and control group (53 cases) by random number table.In the control group,routine treatment was performed according to the sepsis shock guideline,and the combination therapy was carried out.The traditional chinese medicine combined with esmolol group was given the traditional chinese medicine shensongyangxin capsule on the basis of the control group.After 1 week of treatment,the levels of cardiac troponin I (cTnI) in patients before and after treatment were followed up by echocardiography.The cardiac function was evaluated in both groups after treatment,and the incidence of major cardiovascular events (MACE) was compared.Results The level of cTnI in the combination of traditional chinese medicine and esmolol group was significantly lower than that in the control group (P<0.05),and the proportion of cTnI>0.10 μg/L was significantly lower than that of the control group (P<0.01).The left ventricular ejection fraction was higher than that of the control group (P<0.01),and the difference of the incidence of MACE between the two groups was significantly lower than that of the control group (P<0.05) no statistically significant.Conclusion Combination of traditional chinese medicine and esmolol can reduce myocardial inhibition and improve myocardial function.Long-term administration after treatment can improve the left ventricular function of patients.