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目的:探讨连续血液净化(CBP)对重症脓毒症休克伴心肌损伤患者的影响。方法:将60例重症脓毒症休克并心肌损伤患者随机分为对照组(n=31)和CBP组(n=29),比较两组治疗前及治疗48 h时肌酸激酶同工酶(CK-MB)、脑尿钠肽(BNP)、肌钙蛋白(c Tn I)、动脉血乳酸(LAC)、肺泡动脉氧分压差[P(A-a)O2]、APACHEⅡ评分、心输出量(CO)、平均动脉压(MAP)、心率(HR)及28 d病死率。结果:与对照组相比,CBP组CK-MB、BNP、c Tn I、LAC、P(A-a)O2、APACHEⅡ评分明显降低、MAP升高,心动过速明显纠正,28 d病死率明显降低。结论:血液净化对重症脓毒症休克患者并心肌损伤具有保护作用,可改善患者预后。
Objective: To investigate the effect of continuous blood purification (CBP) on patients with severe septic shock and myocardial injury. Methods: Sixty patients with severe septic shock and myocardial injury were randomly divided into control group (n = 31) and CBP group (n = 29). The levels of creatine kinase MB CK-MB, BNP, cTn I, LAC, P Aa O2, APACHE II score, cardiac output ( CO), mean arterial pressure (MAP), heart rate (HR) and 28-day mortality. Results: Compared with the control group, the levels of CK-MB, BNP, cTn I, LAC, P (A-a) O2 and APACHEⅡ in CBP group were significantly decreased, MAP increased, tachycardia corrected significantly, Conclusion: Blood purification has a protective effect on myocardial injury in patients with severe sepsis and improves prognosis.