钟俊,赵佩莹,杨洵,陈亚飞,王迪芬
ZHONG Jun,ZHAO Peiying,YANG Xun,CHEN Yafei,WANG Difen

• 1:贵州省骨科医院重症医学科
• 2:遵义医学院附属贵航300医院重症医学科

摘要(Abstract)：

目的 探讨维生素C治疗在脓毒症患者血清炎症介质、应急反应指标及心肌标记物的影响。方法 将120例脓毒症患者随机均分为治疗组和对照组，治疗组患者在常规治疗基础上给与静滴维生素C治疗，对照组患者在常规治疗基础上给与静滴0.9%氯化钠治疗，对比两组患者的临床疗效；于治疗前、治疗2周时取血检测血清炎症反应指标白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、应激反应指标一氧化氮（NO）、超氧化物歧化酶（SOD）、丙二醛（MDA），检测心肌损伤标志物B型脑利钠肽前体（NT-proBNP）、肌钙蛋白T(cTnT)、心肌酶（CK-MB），同时观察两组患者的机械通气时间、住ICU时间及28 d的死亡率。结果 治疗前，两组脓毒症患者一般情况比较差异无统计学意义（P> 0.05）；治疗后，治疗组患者APACHEⅡ评分、机械通气时间、住ICU时间及28 d死亡率高于对照组（P<0.05），血清IL-6、TNF-α低于对照组、 IL-10高于对照组（P<0.05）；血清NO、MDA均低于对照组，SOD高于对照组（P<0.05）；血清NT-proBNP、cTnT、CK-MB均低于对照组（P<0.05）。结论 脓毒症患者的救治中给予维生素C可减轻患者心肌损伤，其机制可能与维生素C可降低炎症介质水平及减轻机体应激反应水平有关。
Objective To investigate the effects of vitamin C treatment in serum inflammatory mediator,response indicators and myocardium markers of patients with sepsis.Methods One hundred and twenty patients with sepsis were randomly divided into treatment group and control group;treatment group received regular treatment plusⅣvitamin C treatment,control group received regular treatment plusⅣsodium chloride treatment (0.9%) and clinical efficacy were compared later.Interleukin-6 (IL-6),interleukin-10 (IL-10),tumor necrosis factor (TNF-α)，emergency response indicator nitric oxide (NO),superoxide dismutase (SOD),malondialdehyde (MDA),detected myocardium markers Type-B NT-proBNP,troponin (cTnT) and myocardial enzyme (CK-MB) were tested before treatment and 2 weeks after treatment.Mechanical ventilation time,hospitalized time in ICU and mortality rate of 28 d of both groups were recorded.Results Before treatment,general information of both groups showed no statistical significance;after the treatment,APACHE II scores,mechanic ventilation time,hospitalized time in ICT and mortality rate of 28 d of treatment group were higher than control group (P<0.05);serum IL-6,TNF-αof treatment group were lower than that of control group,IL-10 of treatment group were higher than that of control group (P<0.05);serum NO,MDA of treatment group were lower than that of control group,SOD of treatment group were higher than that of control group (P<0.05);serum NT-proBNP,cTnT,and CK-MB of treatment group were lower than that of control group (P<0.05).Conclusion Vitamin C treatment for patients with sepsis can alleviate myocardial damage.Its mechanism might be associated with vitamin C decreasing inflammatory mediator level and alleviating stress response level.

关键词(KeyWords)： 脓毒症;维生素C;炎症反应;氧化应激反应;心肌损伤
sepsis;vitamin C;inflammatory response;oxidative stress;myocardial damage

Abstract:

Keywords:

基金项目(Foundation): 贵州省卫生健康委科学技术基金（gzwjkj2019-2-007）

作者(Author): 钟俊,赵佩莹,杨洵,陈亚飞,王迪芬
ZHONG Jun,ZHAO Peiying,YANG Xun,CHEN Yafei,WANG Difen

DOI: 10.19367/j.cnki.2096-8388.2022.03.011

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