参附注射液对心肺骤停自主循环恢复患者血流动力学和心肌酶学的影响研究

目的:观察参附注射液对心肺骤停自主循环恢复患者血流动力学的影响,并探讨其对心肌细胞损伤的修复作用。方法:将我院急诊科中心ICU内178例心肺骤停自主循环恢复患者随机均分为2组:治疗组给予参附注射液50mL静脉滴注,对照组给予含镁极化液静脉滴注,监测2组治疗前后血流动力学、心肌酶谱(肌酸激酶(CK)、肌酸激酶同功酶(CK-MB)、乳酸脱氢酶(LDH)、天门冬酸氨基转移酶(AST))及心肌肌钙蛋白I(cTnI)的变化情况。结果:复苏后2组患者均出现不同程度的低血压、低心排和心肌损伤。与对照组比较,治疗后治疗组患者血流动力学指标显著改善,心脏泵功能显著增强,心输出量、心指数、每搏输出量显著增加,平均动脉血压显著提高;治疗组CK、CK-MB、LDH、AST、cTnI显著下降。结论:参附注射液可显著改善心肺骤停自主循环恢复患者血流动力学指标,增强心肌收缩力,有效降低心肌酶,对心肺骤停所致心肌细胞缺血缺氧损伤具有明显修复作用。

Study on the Effects of Shenfu Injection on Hemodynamecs and Myocardium Enzyme Profile in Patients with Return of Spontaneous Circulation after Cardiac Arrest

OBJECTIVE:To investigate the effects of Shenfu injection on hemodynamecs in patients after the success of cardiopulmonary resuscitation(CPR),and explore the protective effects of which on myocardial injury. METHODS: A total of 178 patients with return of spontaneous circulation in central intensive care unit were randomly assigned to receive 50 mL Shenfu injection iv gtt(group SF) or Mg-contained polarized solution(control group). Hemodynamic indexes were monitored,and serum myocardium enzymes(CK) and cardiac troponin I(CTn I) were determined simultaneously before and after treatment. RESULTS: Patients in both group presented with low blood pressure BP,low cardiac output and myocardial injury after CPR. In the treatment group compared with control group,the hemodynamic indexes were markedly improved,the cardiac pumping function,cardiac output,cardiac index,stroke volume and mean arterial pressure were all significantly increased,while serum CK,CK-MB,LDH,AST and CTn I levels were all decreased obviously after treatment.CONCLUSION: Shenfu injection can markedly improve hemodynamic indexes,enhance the myocardial contractile force,effectively decrease serum myocardium enzymes and repair the damage of myocardial cells caused by the myocardial ischemia and anoxemia after cardiac arrest in patients with return of spontaneous circulation after cardiac arrest.