|
|
|
|
|
| Clinical study on protective effect of myocardial injury with Ulinastatin and Xuebijing in treatment of patients with severe pneumonia |
| Yan Shou-chun |
| Shanxi University of Chinese Medicine, Xi xian New Area 712046 China |
|
|
|
|
Abstract Objective To investigate the protective effect of myocardial injury with Ulinastatin and Xuebijing in treatment of patients with severe pneumonia. Methods One hundred and eighteen patients with severe pneumonia and myocardial injury were divided into the comparison group and the test group, each of fifty-nine patients. All patients were treated by anti-infection, fluid resuscitation, improvement of circulation and nutrition support. The comparison group was treated by ulinastatin 900,000 U ivd, qd, for two weeks. The test group was treated by ulinastatin 900,000 U ivd and Xuebijing 100 mL, ivd, qd, for two weeks. It′s detected the change of APACHEⅡ score, cardiac troponin I (cTnI), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), brain natriuretic peptide (BNP), creatine kinase isoenzyme (CK-MB), lactate dehydrogenase (LDH) and other indicators of the two groups before and after treatment. Results The indicators of the APACHEⅡ score, blood cTnI, TNF- α, IL-6, BNP, CK-MB, LDH of the two groups before treatment had no significant (P＞0.05). The indicators of the APACHEⅡ score (after treatment, the comparison group was 21.32±4.67, and the test group is 10.02±2.13), serum cTnI (μg/L: after treatment, the comparison group was 1.96±0.02, and the test group was 1.03±0.03), TNF- α (μg/mL, after treatment, the comparison group is 34.38±6.83, and the test group is 21.01±6.97), IL-6 (μg/mL, after treatment, the comparison group was 375.28±68.69, and the test group was 220.82±68.69), BNP (μg/L, after treatment, the comparison group was 727.40±445.13, and the test group was 355.80±135.79), CK-MB (U/L, after treatment, the comparison group was 155.20±33.20, and the test group was 93.30±25.50), LDH (U/L, after treatment, the comparison group was 522.30±26.80, and the test group was 342.20±48.30) levels of the test group were significantly decrease than the same indicators of the comparison group after treatment (P＜0.01). Conclusion We could add with Ulinastatin and Xuebijing to the common therapy to improve the effect to treat the severe pneumonia with myocardial injury, and reduce the TNF- α, IL-6 levels of the patients with severe pneumonia and myocardial injury, and reduce the myocardial injury of the patients with severe pneumonia.
|
|
|
| About author:: Yan Shou-chun, E-mail: 1679967486@qq.com |
|
|
|
| ［1］Parker MM， Shelhamer JH， Bacharach SL， et al. Profound but reversible myocardial depression in patients with septic shock［J］. Ann Intern Med, 1984， 100(4):483-490.
［2］王伟，王晓静，赵洪，等.血必净对重症肺炎并心衰患者细胞因子及心功能的影响［J］.临床肺科杂志， 2012， 17（4）：603-604.
［3］李辉，李万成，蒋贵平.乌司他丁对COPD患者血清TNF-α、CRP及肺功能的影响［J］.临床肺科杂志， 2011， 16（2）：192-193.
［4］陆再英，钟南山，谢毅，等.内科学［M］.第7版.人民卫生出版社， 2008:19.
［5］Choon-ngarm T, Partpisanu P. Serum cardiac troponin-T as a prognostic marker in septic shock［J］. J Med Assoc Thai， 2008， 91（12）：1818-1822.
［6］龚裕强，孙来芳，曾潍贤，等.成人重症肺炎患者心肌损伤标志物和心功能变化特点［J］.中国急救复苏与灾害医学杂志， 2011， 6（7）：613-615.
［7］Takagi Y， Yasuhara T， Gomi K.Creatine kinase and its isozymes［J］. Rinsho Byori， 2001， 116：52-61.
［8］张忠民.成人重症肺炎患者血清心肌损伤标志物的变化［J］.内科急危重症杂志， 2007， 13（2）：86-87.
［9］Jefic D， Lee JW， Jefic D， et al. Utility of B-type natriuretic peptide an N-terminal Pro B-type natriuretic peptide evaluation of respiratory failure in critically ill patients［J］. Chest， 2005， 128(1)：288-295.
［10］Maeder M， fehr T， Rickli H， et al. Sepsis-associated myocardial dysf—unction: diagnostic and prognostic impact of cardiac troponins and natriuretic peptides［J］. Chest， 2006， 129(5)：1349-1366.
［11］方志成，周昌娥，郑翔，等.血必净联合乌司他丁治疗重症肺炎的临床研究［J］.临床和实验医学杂志， 2013， 12（4）：268-270.
［12］曾凡杰，陈芬兰，陈少媚，等.乌司他丁联合血必净注射液对脓毒性休克患者心肌损伤的保护作用［J］.广东医学， 2013， 34（4）：616-618.
［13］景炳文．乌司他丁在急危重症临床应用的进展［J］．中国危重病急救医学， 2006， 18(2): 117-120．
［14］王宇，马朋林.乌司他丁对急性心肌梗死合并心源性休克患者循环功能恢复的影响［J］.中国危重病急救医学，2009，21(9)：562-563．
［15］李银平.关于乌司他丁临床使用问题的研讨——重症医学专家座谈纪要［J］.中国危重病急救医学， 2011， 23(11)：703-704． |
|
|
|
Address: 1 North 2nd Street,
Zhongguancun, 
