左西孟旦和多巴酚丁胺对降低脓毒性心肌病患者外周血白细胞介素-6水平和改善心功能的疗效:一项比较研究。

IF 2 4区 医学 Q3 PHYSIOLOGY Journal of Physiology and Pharmacology Pub Date : 2024-08-01 Epub Date: 2024-10-10 DOI:10.26402/jpp.2024.4.05
T Sun, Q-L Sun, Y Liu, Y-Y Zhang, P Sheng, N Cui, N Zhang, S-H Wang, D Su
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引用次数: 0

摘要

在严重脓毒性心肌病患者中,研究发现左西孟旦比多巴酚丁胺能更有效地改善心肌收缩力,但其潜在机制仍不清楚。本研究旨在比较左西孟旦和多巴酚丁胺对脓毒性心肌病患者心功能和炎症指标的影响,并进一步探讨两种治疗方法的优缺点。我们纳入了 2020 年 9 月至 2023 年 9 月期间在我院重症监护室接受治疗的 40 例脓毒性心肌病患者。患者被随机分为左西孟旦组(20 人)和多巴酚丁胺组(20 人)。在治疗开始、24 小时和 48 小时时,用免疫荧光法测定血浆中白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)和肿瘤坏死因子-α(TNF-α)的浓度。心肌肌钙蛋白 I(cTnI)浓度采用化学发光法测定,左心室射血分数(LVEF)采用辛普森法测定。治疗 24 小时后,两组的 IL-6、IL-1β 和 TNFα 水平无明显差异(P>0.05)。但在 48 小时时,左西孟旦组的 IL-6 水平明显低于多巴酚丁胺组(319.43±226.05 pg/ml vs. 504.57±315.20 pg/ml,P=0.039),而 IL-1β 和 TNF-α 水平无明显差异(P>0.05)。此外,左西孟旦组 cTnI 水平显著低于多巴酚丁胺组(1.01±0.54 ng/ml vs. 1.40±0.63 ng/ml,P=0.042),左西孟旦组 LVEF 显著高于多巴酚丁胺组(50.60±6.11% vs. 46.90±4.95%,P=0.042)。这些研究结果表明,与多巴酚丁胺相比,左西孟旦可降低脓毒症心肌病患者的血浆IL-6水平,减轻心肌损伤,改善心肌收缩力。
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The efficacy of levosimendan and dobutamine on reducing peripheral blood interleukin-6 levels and improving cardiac function in patients with septic cardiomyopathy: a comparative study.

In patients with severe septic cardiomyopathy, levosimendan has been found to improve myocardial contractility more effectively than dobutamine, although the underlying mechanisms remain unclear. This study aims to compare the effects of levosimendan and dobutamine on cardiac function and inflammatory markers in patients with septic cardiomyopathy, and to further investigate the advantages and disadvantages of both treatments. We included 40 patients with septic cardiomyopathy treated in the intensive care unit of our hospital from September 2020 to September 2023. The patients were randomly divided into a levosimendan group (n=20) and a dobutamine group (n=20). Plasma concentrations of interleukin-6 (IL-6), interleukin-1beta (IL-1β), and tumor necrosis factor-alpha (TNF-α) were measured by immunofluorescence at the start of treatment, 24 hours, and 48 hours. Cardiac troponin I (cTnI) concentrations were determined by chemiluminescence, and left ventricular ejection fraction (LVEF) was measured using the Simpson method. After 24 hours of treatment, there were no significant differences in IL-6, IL-1β, and TNFα levels between the two groups (P>0.05). However, at 48 hours, the IL-6 level in the levosimendan group was significantly lower than that in the dobutamine group (319.43±226.05 pg/ml vs. 504.57±315.20 pg/ml, P=0.039), while IL-1β and TNF-α levels showed no significant differences (P>0.05). Additionally, the cTnI level in the levosimendan group was significantly lower than that in the dobutamine group (1.01±0.54 ng/ml vs. 1.40±0.63 ng/ml, P=0.042), and LVEF was significantly higher in the levosimendan group (50.60±6.11% vs. 46.90±4.95%, P=0.042). These findings suggest that levosimendan may reduce plasma IL-6 levels, alleviate myocardial injury, and improve myocardial contractility in patients with septic cardiomyopathy compared to dobutamine.

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来源期刊
CiteScore
4.00
自引率
22.70%
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0
审稿时长
6-12 weeks
期刊介绍: Journal of Physiology and Pharmacology publishes papers which fall within the range of basic and applied physiology, pathophysiology and pharmacology. The papers should illustrate new physiological or pharmacological mechanisms at the level of the cell membrane, single cells, tissues or organs. Clinical studies, that are of fundamental importance and have a direct bearing on the pathophysiology will also be considered. Letters related to articles published in The Journal with topics of general professional interest are welcome.
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