曲美他嗪治疗脓毒症心肌损伤的临床研究

目的:探讨曲美他嗪对脓毒症患者心肌损伤的保护作用。方法:将脓毒症伴有心肌损伤的32例患者按照随机数字表法分为观察组和对照组，各16例；对照组给予常规治疗，观察组在常规治疗基础上加用曲美他嗪，每次20 mg，口服或鼻饲，每天3次，连用7 d。观察2组治疗前及治疗第8天的心肌坏死指标、脑钠肽和病情严重程度的变化；并计算治疗前及治疗第8天的急性生理和慢性健康状况Ⅱ（APACHEⅡ）评分。结果:观察组治疗第8天心肌肌钙蛋白I、脑钠肽水平及APACHEⅡ评分与对照组差异均有统计学意义（P<0.01），但肌酸激酶同工酶与对照组差异无统计学意义（P>0.05）。结论:曲美他嗪能够改善脓毒症患者的心肌损伤，且对患者心功能及病情的改善有益。

Clinical research of trimetazidine in the treatment of myocardial injury in sepsis

Objective:To explore the protective effects of trimetazidine on myocardial injury in patients with sepsis. Methods:Thirty-two sepsis patients with myocardial injury were divided into the treatment group and control group according to the method of random number table(16 cases each group). The control group were treated with conventional therapy,and the treatment group were additionally treated with trimetazidine based on the conventional therapy,20 mg per time,oral or nasal feeding,3 times per day for 7 days. The myocardial necrosis index,brain natriuretic peptide and severity of disease were observed before treatment and after 8 days of treatment. The scores of acute physiology and chronic health evaluationⅡscore( APACHEⅡ) were calculated before treatment and after 8 days of treatment. Results:After 8 days of treatment,the differences of the levels of cTnI and brain natriuretic peptide,and APACHE Ⅱ score between two groups were statistically significant(P<0. 01),and the difference of the level of CK-MB between two groups were not statistically significant(P >0. 05). Conclusions:Trimetazidine can improve the myocardial injury in patients with sepsis,which is beneficial to the cardiac function and disease.