武汉第一医院重症医学科.阿托伐他汀对脓毒症合并高脂血症患者心肌损伤的干预作用[J].内科急危重症杂志,2015,21(5):
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| DOI： |
| 中文关键词: 阿托伐他汀 脓毒症 心肌保护 |
| 英文关键词:atorvastatin sepsis myocardial protection |
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| 中文摘要: |
| 目的 探讨阿托伐他汀对脓毒症合并高脂血症伴发心肌损伤患者受损心肌的干预作用。方法 将40例脓毒症合并高脂血症伴发心肌损伤患者随机分为对照组与治疗组，每组20例。对照组按照脓毒症指南进行治疗；治疗组，在对照组治疗基础上，加用阿托伐他汀40mg，1次/天，连用7 d。观察两组患者治疗前后心肌肌钙蛋白 I （cTnI）、肌酸激酶同工酶（CK-MB）、 乳酸脱氢酶（LDH）、脑钠肽（BNP）的变化。同时观察治疗组治疗前后丙氨酸氨基转移酶(ALT)、γ-谷氨酰转肽酶（γ-GT）、碱性磷酸酶(ALP)的变化。结果 两组患者治疗前APACHEⅡ评分、cTnI、CK-MB、 LDH、BNP水平差异无统计学意义（p>0.05）；治疗7天后，治疗组与对照组比较，cTnI、CK-MB、 LDH、BNP水平均下降（p<0.05）。
对照组治疗后ALT、γ-GT稍有升高(p>0.05)，但未达正常上限；ALP治疗前后差异无统计学意义(p<0.05)。结论 阿托伐他汀40 mg／d，对脓毒症合并高脂血症伴发心肌损伤患者的心肌有一定的保护作用，对肝功能的影响较小。 |
| 英文摘要: |
| Objective To investigate the intervention effects of atorvastatin on injuried myocardium in septic patients with myocardial injury and hyperlipidemia . Methods 40 cases of sepsis patients with myocardial injury and hyperlipidemia were randomly divided into control group and treatment group，20 cases in each group. The control group were treated with sepsis guidelines. Besides the treatment in control group，patients in treatment group received atorvastatin 40mg once a day for 7 days. Two groups were observed before and after treatment in patients with cardiac troponin I (cTnI)，creatine kinase isoenzyme (CK-MB)， lactate dehydrogenase (LDH)，brain natriuretic peptide (BNP) changes. The treatment group were observed before and after treatment in patients with the alanine aminotransferase (ALT)，gamma glutamyl transpeptidase (gamma -GT)，alkaline phosphatase (ALP) changes. Results Before treatment，APACHE Ⅱscore，cTnI，CK-MB，LDH，BNP levels had no statistical difference in two groups (p>0.05)；7 days after treatment，cTnI，CK-MB， LDH， BNP levels were decreased in treatment group ，compared with the control group . (p<0.05). After treatment ，ALT，gamma -GT increased slightly (p>0.05)，but did not reach the upper limit of normal．ALP had no significant difference before and after the treatment (p<0.05) in the control group.Conclusion Atorvastatin 40 mg once a day ，has certain protective effect on injuried myocardium in septic patients with myocardial injury and hyperlipidemia and has little effect on liver function． |
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