Effect of Shenmai Injection Combined with Metoprolol on APACHE Ⅱ Score and Expression of Serum MiR- 133a- 3p and NT- proBNP in Patients with Septic Shock Complicated with Myocardium Damage
Abstract:Objective:To observer the effect of Shenmai injection combined with metoprolol on score of Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) and the expression of miR- 133a- 3p and N- terminal pro- brain natriuretic petide(NT-proBNP) in serum in patients with septic shock(SS) complicated with myocardium damage(MD). Methods:A total of 90 cases of patients with SD complicated with MD were selected and divided into the combination group, the control group A,and the control group B according to the treatment schemes,30 cases in each group. Based on routine treatment, the control group A was additionally treated with metoprolol; the control group B was additionally treated with Shenmai injection;the combination group was treated with metoprolol and Shenmai injection. The comparison of APACHE Ⅱ score, multiple organ dysfunction syndrome(MODS), the expression levels of miR- 133a- 3p and NT- proBNP in serum, mean arterial pressure(MAP), heart rate(HR), cardiac output index(CI), superoxide dismutase(SOD), malondialdehyde(MDA), tumor necrosis factor- α(TNF- α),interleukin- 6(IL-6) and interleukin- 1 β(IL-1 β) were conducted among the three groups before treatment and after one-week treatment. The incidence of adverse reactions during treatment was compared among the three groups. Results:After one-week treatment,the scores of APACHE Ⅱ and MODS,as well as the levels of miR- 133a- 3p,NT- proBNP,HR,CI,MDA,TNF- α,IL- 6,IL- β in the three groups were decreased when compared with those before treatment(P<0.05),and the indexes above in the combination group were lower than those in the control group A and the control group B(P<0.05). After one-week treatment,the levels of MAP and serum SOD in the three groups were increased when compared with those before treatment(P<0.05),and the two levels above in the combination group were higher than those in the control group A and the control group B(P<0.05). During treatment, there was no significant difference being found in the comparison of incidence of adverse reactions among the three groups(P>0.05). Conclusion: The therapy of Shenmai injection combined with metoprolol in the treatment of SS complicated with MD can relieve oxidative stress and inflammation damage,and improve hemodynamics. The combination therapy can improve curative effect without any increase in the risk of adverse reactions.