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右美托咪定对脓毒症合并心肌损伤患者的临床效果。

Clinical effects of dexmedetomidine on patients with sepsis and myocardial injury.

机构信息

Department of Cardiopulmonary Rehabilitation Center, Shiyan Taihe Hospital Affiliated to Hubei Medical College, Shiyan, Hubei, China.

Department of Cardiology, Guangzhou Xinshi Hospital, Guangzhou, Guangdong, China.

出版信息

Medicine (Baltimore). 2024 Oct 25;103(43):e40257. doi: 10.1097/MD.0000000000040257.

Abstract

This study aimed to explore the organ-protective effects of dexmedetomidine in patients with sepsis combined with myocardial injury. From December 2021 to December 2023, 263 sepsis patients with myocardial injury were included based on inclusion and exclusion criteria. They were divided into an experimental group (n = 122), who had previously received dexmedetomidine, and a control group (n = 141), who had received midazolam. After matching baseline characteristics, the treatment outcomes between the 2 groups were compared. In a propensity score-matched cohort of 263 patients, each group had 62 individuals with balanced baseline characteristics. The experimental group showed significantly lower heart rates on days 1, 3, and 7 compared to the control (P < .05). Biomarkers high-sensitivity troponin I and creatine kinase-MB decreased significantly by days 3 and 7, with lower levels in the experimental group. B-type natriuretic peptide levels were also lower in the experimental group on days 3 and 7. Heart function improved in both groups, with the experimental group showing better outcomes. Inflammatory markers decreased significantly after 7 days, with the experimental group having lower levels. Hospitalization duration was similar between groups. Dexmedetomidine reduces heart rate and inflammatory markers, protects myocardial cells, and improves cardiac function in patients with sepsis and myocardial injury. It shows potential as a treatment option, with future research needed to assess its long-term efficacy and safety.

摘要

本研究旨在探讨右美托咪定对脓毒症合并心肌损伤患者的器官保护作用。根据纳入和排除标准,纳入了 2021 年 12 月至 2023 年 12 月期间 263 例脓毒症合并心肌损伤患者。他们被分为实验组(n=122)和对照组(n=141),实验组之前接受过右美托咪定,对照组接受过咪达唑仑。在匹配基线特征后,比较两组的治疗结果。在 263 例患者的倾向评分匹配队列中,每组各有 62 例基线特征平衡的患者。实验组在第 1、3 和 7 天的心率明显低于对照组(P<.05)。第 3 和 7 天,生物标志物高敏肌钙蛋白 I 和肌酸激酶同工酶 MB 明显下降,实验组水平较低。第 3 和 7 天,实验组的 B 型利钠肽水平也较低。两组心功能均有改善,实验组效果更好。第 7 天炎症标志物明显下降,实验组水平较低。两组住院时间相似。右美托咪定可降低脓毒症合并心肌损伤患者的心率和炎症标志物,保护心肌细胞,改善心功能。它具有作为治疗选择的潜力,需要进一步研究评估其长期疗效和安全性。

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