尼可地尔对脓毒症心肌病患者的疗效及预后影响

Efficacy of nicorandil in patients with sepsis-induced cardiomyopathy and its effects on prognosis

摘要:

目的 探讨尼可地尔对脓毒症心肌病(SIC)患者的疗效及预后。方法 纳入2019年5月至2020年3月在徐州医科大学附属医院重症监护室收治的SIC患者80例,随机数表法将患者分为对照组(C组)40例和尼可地尔组(N组)40例。C组给予标准抗脓毒症治疗,N组在规范抗毒症治疗基础上加用尼可地尔,2组均连续治疗 7d。检测2组患者治疗前后心功能和心肌损伤标志物情况；观察2组患者治疗前后序贯器官衰竭评估(SOFA)和急性生理学与慢性健康状况评价Ⅱ(APACHE Ⅱ)变化。采用SPSS 22.0软件进行数据分析。组间及组内比较采用t检验,Mann-Whitney U检验和χ²检验。 结果 治疗后,N组患者在心功能、心肌损伤标志物、SOFA评分、APACHEⅡ评分等方面效果均优于对照组 (均P<0.05),不良心脏事件例数均减少(均P<0.05)。 结论 与标准治疗相比,应用尼可地尔可减少SIC患者心肌损伤,改善心功能,稳定病情,改善预后。

Abstract:

Objective To explore the efficacy of nicorandil in the patients with sepsis-induced cardiomyopathy (SIC) and its effect on the prognosis. Methods A total of 80 SIC patients admitted to the Intensive Care Unit of the Affiliated Hospital of Xuzhou Medical University from May 2019 to March 2020 were selected and randomly divided into control group and nicorandil group, with 40 in each group. Both groups were given standard anti-septic treatment. Nicoranolil group were given additional nicorandil injection. All patients were treated for consecutive 7 days. Cardiac function and markers of myocardial injury were assessed before and after treatment. Sequential organ failure assessment (SOFA) and changes in acute physiology and chronic health evaluation system Ⅱ (APACHE Ⅱ) were observed before and after treatment. SPSS statistics 22.0 was used for data analysis. Inter-group and intra-group comparison was made using t-test, Mann-Whitney U test and χ² test. Results After treatment, patients in nicorandil group were found to be better than patients in control group in cardiac function, myocardial injury markers,SOFA and APACHE Ⅱ, with statistically significant difference (all P＜0.05). The number of adverse cardiac events during hospitalization and the incidence of severe arrhythmia were significantly decreased in nicorandial group (all P<0.05). Conclusion Compared with standard treatment, nicorandil can reduce myocardial damage in the SIC patients, improve their cardiac function, stabilize the condition, and enhance the prognosis.