【摘要】 目的 观察参麦注射液对感染性休克患者血流动力学、炎症指标及组织灌注的影响。方法 将感染性休克患者60例，按随机数字表法分为治疗组与对照组各30例。两组均给予基础西医对症治疗，治疗组在西医常规治疗基础上静脉滴注100 m L参麦注射液。观察两组治疗前后血流动力学指标，使用前后不同时间的心率（HR）、平均动脉压（MAP）、心排指数（CI）、全心舒张末期容积指数（GEDVI）、胸腔内血容积指数（ITBVI）、全身血管阻力指数（SVRI）、血管外肺水指数（EVLWI）的影响。观察两组不同时间的心功能指标NT-proBNP、感染指标降钙素原（PCT）水平。观察两组治疗前后不同时间的组织灌注指标变化，如动脉血乳酸（Lac）、APACHEⅡ评分变化。结果 治疗后两组之间HR、MAP差异无统计学意义（P> 0.05）。CI、GEDVI、ITBVI、SVRI、EVLWI治疗组较对照组有所好转，但差异无统计学意义（P> 0.05）。治疗后治疗组心功能指标NT-proBNP、PCT、血乳酸水平低于对照组（P <0.05），两组APACHEⅡ评分好转率差异无统计学意义（P> 0.05）。结论参麦注射液在治疗老年人脓毒血症过程中，有一定的改善心功能、降低血管阻力、改善炎症指标的作用，可以在老年人脓毒血症治疗过程中作为辅助用药。但无法作为强心药物来治疗脓毒血症，也无法替代其他免疫调节性药物来改善全身症状。更多还原

【Abstract】 Objective:To observe the effect of Shenmai Injection on hemodynamics,inflammatory indexes and tissue perfusion in patients with septic shock. Methods:A total of 60 patients with septic shock were selected and divided into experimental group and control treatment group according to random number table method,30 cases in each group. The two groups were given basic western medicine symptomatic treatment,and the experimental group received 100 m L of Shenmai Injection intravenously on the basis of conventional western medicine treatment. The hemodynamic indexes before and after treatment,heart rate(HR),mean arterial pressure(MAP),cardiac output index(CI),global end-diastolic volume index(GEDVI)and intrathoracic blood volume index(ITBVI),systemic vascular resistance index(SVRI),and extravascular lung water index(EVLWI)at different times before and after treatment in the two groups were observed. The effects of cardiac function index NT-proBNP and infection index procalcitonin(PCT)were observed in the two groups of patients at different times before and after treatment.The changes of tissue perfusion indexes,such as arterial blood lactic acid(Lac)and APACHEⅡ score,were observed at different times before and after treatment in the two groups. Results:There was no significant difference in HR and MAP between the two groups after treatment(P > 0.05). Compared with the control group,the levels of CI,GEDVI,ITBVI,SVRI and EVLWI in the treatment group were better than those of the control group,but the differences were not statistically significant(P > 0.05). The cardiac function indexes NT-proBNP,PCT and blood lactate levels in the experimental groups decreased compared with the control group(P < 0.05),while the APACHEⅡ score improved,but with no significant difference(P > 0.05). Conclusion:Shenmai Injection can improve heart function,reduce vascular resistance,and improve inflammatory indicators in the process of treating sepsis in the elderly. It can be used as an adjuvant drug in the treatment of sepsis in the elderly. However,it cannot be used as a cardiotonic drug to treat sepsis,nor can it replace other immunomodulatory drugs to improve systemic symptoms.更多还原