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目的:研究阿托伐他汀联合低分子肝素抗凝治疗对脓毒症患者炎症因子、心肌损伤标志物及应激氧化相关指标水平的影响。方法:选取新乡医学院第一附属医院2013年3月至2016年3月108例脓毒症患者为研究对象,将纳入患者抽签随机分为联合组与抗凝组,每组54例。抗凝组在常规治疗基础上给予低分子肝素,联合组在常规治疗基础上给予阿托伐他汀联合低分子肝素,比较两组炎症因子指标、氧化应激指标、心肌损伤标志物、生存率、不良反应发生率。结果:联合组治疗5 d后的肿瘤坏死因子α(TNF-α)、丙二醛(MDA)、心肌肌钙蛋白I(cTnI)分别为(114.35±36.17)μg·L~(-1)、(3.14±1.35)μmol·L~(-1)、(0.76±0.25)μg·L~(-1)显著低于抗凝组的(158.64±28.94)μg·L~(-1)、(4.76±1.38)μmol·L~(-1)、(1.08±0.59)μg·L~(-1)(P<0.5)。结论:阿托伐他汀联合低分子肝素抗凝治疗脓毒症,可以抑制炎性细胞因子释放,恢复氧化与抗氧化系统平衡,缓解心肌损伤,降低患者死亡率。
Objective: To study the effects of atorvastatin combined with low molecular weight heparin anticoagulant therapy on inflammatory cytokines, markers of myocardial injury and related indicators of stress and oxidative stress in sepsis patients. Methods: From January 2013 to March 2016, 108 cases of sepsis patients in the First Affiliated Hospital of Xinxiang Medical College were selected as the study objects. The patients enrolled in the study were randomly divided into the combined group and the anticoagulant group. The anticoagulant group was given low molecular weight heparin on the basis of routine treatment. The combination group was given atorvastatin combined with low molecular weight heparin on the basis of routine treatment. The inflammatory cytokines, oxidative stress indexes, myocardial injury markers, survival rate, Adverse reaction rate. Results: The levels of tumor necrosis factor alpha (TNF-α), malondialdehyde (MDA) and cardiac troponin I (cTnI) were (114.35 ± 36.17) μg · L -1, (3.14 ± 1.35) μmol·L -1, (0.76 ± 0.25) μg · L -1 were significantly lower than those in the anticoagulation group (158.64 ± 28.94 μg · L -1, 4.76 ± 1.38) μmol·L -1, (1.08 ± 0.59) μg · L -1 (P <0.5). Conclusion: Atorvastatin combined with low molecular weight heparin anticoagulant therapy for sepsis can inhibit the release of inflammatory cytokines, restore the balance between oxidation and antioxidant system, relieve myocardial injury and reduce mortality.