参麦注射液联合美托洛尔对感染性休克并心肌损伤患者APACHEⅡ评分及对血清miR-133a-3p、NT-proBNP 表达的影响
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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
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    摘要:

    目的:观察参麦注射液联合美托洛尔对感染性休克(SS) 并心肌损伤(MD) 患者急性生理学与慢性健康状况评分系统Ⅱ (APACHEⅡ) 评分及对血清miR-133a-3p、氨基末端脑利钠肽前体(NT-proBNP) 表达的影响。方法:选取90 例SS 并MD 患者,按治疗方案分为联合组、对照A 组、对照B 组,各30 例。在常规治疗基础上,对照A 组予美托洛尔治疗,对照B 组予参麦注射液治疗,联合组予参麦注射液联合美托洛尔治疗。对比3 组治疗前、治疗1 周后APACHEⅡ评分、多器官功能障碍评分(MODS)、血清miR-133a-3p、NT-proBNP、平均动脉压(MAP)、心率(HR)、心排血指数(CI)、超氧化物歧化酶(SOD)、丙二醛(MDA)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6 (IL-6)、白细胞介素-1β (IL-1β) 水平及治疗期间的不良反应。结果:治疗1 周后,3 组APACHEⅡ、MODS 评分、血清miR-133a-3p、NT-proBNP、HR、CI、MDA、TNF-α、IL-6、IL-1β 水平均较治疗前降低(P<0.05),且联合组低于对照A 组、对照B 组(P<0.05);3 组MAP、血清SOD 较治疗前升高(P<0.05),且联合组高于对照A 组、对照B 组(P<0.05);3 组治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论:参麦注射液联合美托洛尔治疗SS 并MD 能缓解氧化应激、减轻炎症损害、改善血流动力学,提高治疗效果,且不会增加不良反应发生风险。

    Abstract:

    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.

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刘春钢,李晶.参麦注射液联合美托洛尔对感染性休克并心肌损伤患者APACHEⅡ评分及对血清miR-133a-3p、NT-proBNP 表达的影响[J].新中医,2021,53(3):40-44

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  • 在线发布日期: 2021-02-03
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