大剂量纳洛酮联合乌司他丁在急性心源性休克效果分析.docVIP

大剂量纳洛酮联合乌司他丁在急性心源性休克效果分析 　　[摘要] 目的 探讨大剂量纳洛酮联合乌司他丁对急性心源性休克的临床治疗效果。 方法 选取2011年1月―2014年5月于该院心内科接受治疗的急性心肌梗死并心源性休克患者56例，将其随机分成纳洛酮治疗组组21例、乌司他丁治疗组17例、纳洛酮联合乌司他丁治疗组18例。通过心衰标志物脑钠肽以及炎性介导物肿瘤坏死因子-α、白细胞介素-6来评判各组的治疗效果。 结果 治疗7 d之后，3组患者关于评估疗效的3项指标较治疗前都显著下降（P 0.05）；联合治疗组脑钠肽（138.79±54.21）对比纳洛酮组（250.46±66.53）疗效明显（t=3.58，P 0.05）；对比乌司他丁治疗组评判指标下降同样显著（t=4.17，P 0.05），表明联合治疗组疗效更好。结论 大剂量纳洛酮联合乌司他丁在急性心源性休克的治疗当中比单用这两种药具有更好的疗效，值得向临床推广应用。 　　[关键词] 大剂量纳洛酮；乌司他丁；急性心源性休克 　　[中图分类号] R54 [文献标识码] A [文章编号] 1674-0742（2015）02（c）-0098-02 　　[Abstract] Objective To investigate the large dose of naloxone combined with ulinastatin clinical therapeutic effect on acute cardiogenic shock. Methods from 2011 January to 2014 May in our hospital department of Cardiology for treatment of acute myocardial infarction patients with cardiogenic shock in 56 cases， were randomly divided into 21 cases of treatment group， naloxone group， ulinastatin treatment group 17 cases， naloxone combined with ulinastatin treatment group of 18 cases. The biomarker of brain natriuretic peptide and inflammatory mediators of tumor necrosis factor alpha， interleukin -6 to judge the curative effect of each group. Results after 7 days of treatment， the 3 indexes of 3 groups of patients for evaluating curative effect than before treatment were significantly decreased（P 0.05）； Combined treatment group of brain natriuretic peptide（138.79 ± 54.21） contrast naloxone group （250.46 ± 66.53） curative effect obviously （t=3.58， P 0.05）； the contrast of ulinastatin treatment group significantly decreased the same evaluation index （t=4.17， P 0.05）， combined treatment group showed better therapeutic effect. Conclusion large dose of naloxone combined with ulinastatin in the treatment of acute cardiogenic shock than single use of these two kinds of medicine has better curative effect， it is worth to clinical application. 　　[Key words] Large dose naloxone； Ulinastatin； Acute cardiogenic shock 　　伴随着社会的老龄化进程，心肌梗死事件呈逐年增长的趋势，已经日益发展成为威胁老年人身心健康的重要疾病，特别是心肌梗死