血必净对心搏骤停后心肌功能障碍患者保护作用的临床研究

目的探讨血必净对心搏骤停后心肌功能障碍患者的保护作用。方法将2009年10月至2012年1月于ICU收治的成人心肺复苏自主循环恢复后的患者31例随机分为两组。对照组(15例)按常规治疗;治疗组(16例)在常规治疗基础上加用血必净注射液100 ml静脉滴注,每日2次,治疗5 d。记录治疗前及治疗后12 h、24 h、72 h患者的血乳酸、心率(HR)、中心静脉压、平均动脉压、APACHEⅡ评分,检测心肌肌钙蛋白(cTnI)及B型利钠肽(BNP)水平。结果血必净治疗组患者cTnI高峰下降(P>0.05),治疗后72 h较对照组差异有统计学意义(P<0.05);BNP高峰(24 h)明显下降(P<0.05),治疗72 h后两组差异仍有统计学意义。治疗24 h HR增快情况改善(P<0.05),组织灌注改善,治疗24 h及72 h治疗组血乳酸水平下降(P<0.05),各时间点治疗组MAP相对较高,但差异无统计学意义。结论血必净能改善CPR术后患者的血流动力学情况,降低cTnI及BNP水平,对心搏骤停后心肌功能障碍具有一定的保护作用。

A prospective random-control clinical study on efficacy of Xuebijing on post-cardiac arrest myocardial dysfunction

Objective To study the effect of Xuebijing injection on patients with myocardial dysfunction due to post-cardiac arrest.Methods The design was a prospective,randomized,parallel group study in Intensive Care Unit.in this hospital during October 2009 to January 2012,31 adult patients after successful resuscitation of cardiac arrest by restoration of spontaneous circulation（ROSC） with duration exceeding 10 min were randomly divided into two groups whether with Xuebijing injection or not.The number of patients in control group was 15（n=15）,and the number of patients in Xuebijing treatment group was 16（n=16）.These two groups were comparable in terms of sex distribution,age range and APACHEⅡscores.Routine medicine therapy was given in both groups.Additionally,patients in Xuebijing treatment group were additionally intravenously administrated with 50 ml Xuebijing injection,once every 12 hours for consecutive 5 days.The APACHEⅡscores,HR,MAP,CVP were recorded before treatment,and at first 12 hours,24 hours and 72 hours after treatment.Blood samples were taken at each time point from patients in both groups for measuring serum levels of lactic acid,BNP and cTnI.Results Patients in both groups had high levels of cTnI and BNP.The increase in heart rate had been improved at 24 h after treatment with Xuebijing injection（P0.05）.The serum levels of BNP and cTnI were increased in patients of both groups with peak value at 24 hours,then they began to decrease.The serum levels of lactic acid,BNP and cTnI were decreased at 24 h in patients of Xuebijing group compared with those of patients of control group（P0.05）.Conclusion Xuebijing injection can decrease serum levels of cTnI and BNP and alleviate cardiac dysfunction and myocardial injury after cardiopulmonary resuscitation.