二维斑点追踪技术评价血必净注射液治疗脓毒症心功能障碍的疗效研究Evaluation of the Therapeutic Effect of Xuebijing Injection on Sepsis-induced Myocardial Dysfunction by Two-dimensional Speckle Tracking Imaging
吴建鹏,王琳,范丽平,刘廷廷,陶如,余旭超
摘要(Abstract):
目的 采用二维斑点追踪技术评价血必净注射液治疗脓毒症心功能障碍(SIMD)的疗效。方法 SIMD患者66例随机分为观察组与对照组,对照组予西医常规治疗,观察组在对照组基础上加用血必净注射液治疗,采用二维斑点追踪技术观察两组治疗前后心功能指标的变化,最后进行临床疗效评价。结果 两组患者治疗后左室射血分数(LVEF)、径向应变(GRS)均较治疗前升高(P<0.05);观察组治疗后的二尖瓣口舒张早期峰值血流速度(E峰)/舒张早期室间隔侧二尖瓣环根部运动速度峰值(e′)E/e′、纵向应变(GLS)和04-LSRs均较治疗前改善(P<0.01),03-LSRs较治疗前改善(P<0.05);治疗后,观察组E/e′、GLS和04-LSRs均较对照组改善(P<0.05),对照组GLS系列指标治疗前后差异均无统计学意义(P>0.05)。结论 血必净注射液对脓毒症心功能障碍疗效确切,能改善心脏的收缩功能和舒张功能。
关键词(KeyWords): 脓毒症心功能障碍;二维斑点追踪技术;血必净注射液;心功能
基金项目(Foundation): 西安市中医药科研项目(SZL201938,SZL202113)
作者(Author): 吴建鹏,王琳,范丽平,刘廷廷,陶如,余旭超
参考文献(References):
- [1]Ravikumar N,Sayed MA,Poonsuph CJ,et al.Septic cardiomyopathy:from basics to management choices[J].Curr Probl Cardiol,2021,46(4):100767.
- [2]Vallabhajosyula S,Kumar M,Pandompatam G,et al.Prognostic impact of isolated right ventricular dysfunction in sepsis and septic shock:an 8-year historical cohort study[J].Ann Intensive Care,2017,7(1):94.
- [3]Zaky A,Deem S,Bendjelid K,et al.Characterization of cardiac dysfunction in sepsis:an ongoing challenge[J].Shock,2014,41(1):12-24.
- [4]Hochstadt A,Meroz Y,Landesberg G.Myocardial dysfunction in severe sepsis and septic shock:more questions than answers[J].Journal of Cardiothoracic&Vascular Anesthesia,2011,25(3):526-535.
- [5]Singer M,Deutschman CS,Seymout CW,et al.The third international consensus definitions for sepsis and septic shock(sepsis-3)[J].JAMA,2016,315(8):801-810.
- [6]Vallabhajosyula S,Jentzer JC,Geske JB,et al.New-onset heart failure and mortality in hospital survivors of sepsis-related left ventricular dysfunction[J].Shock,2018,49(2):144-149.
- [7]贾依娜尔,董岩,杨立新.脓毒症心肌病的危险因素分析[J].内科急危重症杂志,2020,26(2):122-125.
- [8]余雷,孙荣青.脓毒症心功能障碍患者评估及治疗进展[J].中华危重病急救医学,2019,31(3):378-380.
- [9]Sanfilippo F,Corredor C,Fletcher N,et al.Diastolic dysfunction and mortality in septic patients:a systematic review and meta-analysis[J].Intensive Care Med,2015,41(6):1004-1013.
- [10]Huang SJ,Nalos M,Mc Lean AS.Is early ventricular dysfunctionor dilatation associated with lower mortality rate in adult severesepsis and septic shock A meta-analysis[J].Crit Care,2013,17(3):R96.
- [11]Ng PY,Sin WC,Ng AKY,et al.Speckle tracking echocardiography in patients with septic shock:a case control study(SPECKSS)[J].Crit Care,2016,20(1):145.
- [12]Hai PD,Phuong LL,Dung NM,et al.Subclinical left ventricular systolic dysfunction in patients with septic shock based on Sepsis-3 definition:A speckle-tracking echocardiography study[J].Crit Care Res Pract,2020,9(11):6098654.
- [13]Innocenti F,Palmieri V,Stefanone VT,et al.Prognostic stratification in septic patients with overt and cryptic shock by speckle tracking echocardiography[J].Intern Emerg Med,2021,16(3):757-764.
- [14]王印华,王宝华.血必净注射液对脓毒症患者的免疫调理作用[J].中国中西医结合急救杂志,2021,28(2):132-135.
- [15]张嘉雯,贺园莉,史阳,等.血必净注射液治疗脓毒症血管内皮损伤有效性及安全性的Meta分析[J].海南医学院学报,2021,27(12):910-917.
- [16]吴玉娇,张晶,漆立军,等.血必净注射液治疗脓毒症临床疗效和安全性的Meta分析[J].中华危重病急救医学,2020,32(6):691-695.
- [17]Song Y,Yao C,Yao Y,et al.Xue Bi Jing Injection versus placebo for critically ill patients with severe community-acquired pneumonia:A randomized controlled trial[J].Crit Care Med,2019,47(9):735-743.
- [18]Guo H,Zheng J,Huang G,et al.Xuebijing injection in the treatment of COVID-19:a re trospective case-control study[J].Ann Palliat Med,2020,9(5):3235-3248.
- [19]姚刚,丁艳,于杰.血必净注射液联合高压氧治疗对脓毒症心肌损伤患者血管内皮损伤及微循环的影响[J].中华航海医学与高气压医学杂志,2021,28(2):169-173.
- [20]张宏伟,魏立友,赵刚,等.血必净注射液对老年脓毒症患者心肌损伤的保护作用[J].中国老年学杂志,2017,37(19):4863-4865.
- [21]何健卓,尹鑫,马世玉,等.血必净注射液对脓毒症大鼠心功能及内皮功能的影响[J].中西医结合心脑血管病杂志,2017,15(14):1710-1715.
- [22]孟繁甦,刘勇,罗泽坤,等.血必净注射液对脓毒症大鼠心肌细胞凋亡保护作用的机制研究[J].中国中医急症,2019,28(3):418-421.