Study of calcium channel blockers on prevention and treatment of patients with severe burn sepsis
10.3760/cma.j.issn.1008-6315.2010.09.001
- VernacularTitle:钙通道阻滞剂在危重烧伤脓毒症防治中的应用
- Author:
Zuhuang WU
;
Bin SONG
;
Cuoyang CHEN
;
Guangyi WANG
- Publication Type:Journal Article
- Keywords:
Burn;
Calcium channel blockers;
Sepsis;
Hemodynamics;
Calcium homeostasis
- From:
Clinical Medicine of China
2010;26(9):897-900
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the effect of nimodipine on prevention and treatment of patients with severe burn sepsis. MethodsTwenty-eight cases were randomized into nimodipine treatment group (n = 14) and routine group (n = 14). Besides general chnical therapy scheme treatment,the treatment group was administrated with saline plus nimodipine (15 μg/(kg · h)), while the routine group was given saline only. The Plasma concentration levels of total calcium (Ca2 +), free calcium (iCa2 +), C-reactive protein (CRP), procalcitonin (PCT), tunmor necrosis factor α (TNF-α), brain natriuretic petide (BNP) and interleukin-6 (IL-6) were measured. The hemodynamic indices of patients with severely burn sepsis were determined by transesophageal echo-Doppler device,hemodynamic indices including aortic blood flow (ABF), left ventricle ejection time (LVET), max acceleration (ACC), total systemic vascular resistance (TSVR). Mean artery pressure (MAP) and heart rate (HR) were measured. ResultsABF, ACC, LVET and TSVR were improved after therapy in the routine group(t = 3.93,3. 37,3.75,7.02) (P ＜ 0.01 or 0.05). ABF, ACC, LVET and TSVR were mproved after therapy in the treatment group (t =6.46,4.98,6.29,4.60) (P ＜0.01 or 0.05). ABF, ACC and LVET were increased after general clinical therapy scheme and was markedly increased in the treatment group (t = 2.29,2.07,2.23)(P＜0.01～0.05).TSVR was decreased after general clinical therapy scheme and was markedly decreased in the treatment group (t =2.14) (P＜0.05). Plasma TNF-α, IL-6 and CRP levels were decreased after therapy in the routine group (t =2.38,2.29,2.45)(P＜0.01 or 0.05). Plasma TNF-α, IL-6 and CRP levels were decreased after therapy in the treatment group (t =4.04,4.04,2.56)(P ＜0.01or 0.05). Plasma PCT and BNP levels were decreased in the treatment group (t =5.45,2. 44) (P ＜ 0.01 or 0.05). TNF-α, IL-6, CRP, PCT and BNP were decreased after generalclinical therapy scheme and was markedly decreased in the treatment group (t = 2.20,2.17,2.19,2.17,2.61) (P ＜0.01 or 0.05). Plasma Ca2+ and iCa2+ levels were decreased. However,MAP were increased in the two groups, although no difference was found between the two group(P ＞0.05). ConclusionsEarly applying of calcium channel blockers (CCB) can markedly inhibit the degree of inflammatory medium in serum, thereby preventing the development of excessive inflammation response and subsequent multiple organ dysfunction syndrome associated with severely burned sepsis. It can effectively inhibit intracellular Ca2+ overload caused by myocadial infection injury,which may contribute to the effect of acupuncture in reducing myocardial injury and protecting myocardial performance and improving prognosis.
