摘要目的:探究高压氧（HBO）联合左西孟旦对脓毒症心肌损伤患者血管内皮功能及心肌酶谱的影响。方法:2021年1月至2022年1月，商丘市第一人民医院收治脓毒症心肌损伤患者120例，采用随机数字表法将患者分为对照1组、对照2组和研究组，每组40例。对照1组患者给予HBO治疗，对照2组患者给予左西孟旦治疗，研究组给予HBO联合左西孟旦治疗。比较3组患者治疗前后血管内皮功能指标及心肌酶谱指标水平差异。结果:治疗后3组患者血清内皮素-1（ET-1）、血管假性血友病因子（vWF）水平较治疗前降低，且研究组低于对照1组、对照2组，差异均有统计学意义（ P<0.05）；治疗后3组患者一氧化氮（NO）水平升高，且研究组高于对照1组、对照2组，差异均有统计学意义（ P<0.05）。治疗后3组患者α-羟丁酸脱氢酶（α-HBDH）、肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）、天冬氨酸转氨酶（AST）、肌钙蛋白Ⅰ（cTnⅠ）水平较治疗前降低，且研究组低于对照1组、对照2组，差异均有统计学意义（ P<0.05）；治疗后3组患者SOD水平升高，且研究组高于对照1组、对照2组，差异均有统计学意义（ P<0.05）。 结论:HBO联合左西孟旦应用于脓毒症心肌损伤患者可有效改善血管内皮功能，改善心肌酶谱水平。

abstractsObjective:To explore the effect of hyperbaric oxygen combined with levosimendan on vascular endothelial function and myocardial zymogram indexes in patients with sepsis myocardial injury.Methods:A total of 120 patients with sepsis myocardial injury admitted to the First People’s Hospital of Shangqiu from January 2021 to January 2022 were prospectively selected by the random number table method，who were then divided into control group 1，control group 2，and study group，with 40 cases in each group. The patients in the control group 1 were treated with hyperbaric oxygen therapy；the patients in the control group 2 were treated with levosimendan；the patients in the study group were treated with hyperbaric oxygen therapy and levosimendan. After two courses of treatment，the levels of vascular endothelial function indexes and myocardial zymogram indexes were compared.Results:Compared with before treatment，the levels of serum endothelin-1（ET-1）and von Willebrand factor（vWF）in the three groups decreased，and the levels of ET-1 and vWF in the study group were lower than those in control group 1 and control group 2；the levels of nitric oxide（NO）increased after treatment，and the levels of NO in the study group were higher than those in control group 1 and control group 2；all the differences were statistically significant（ P<0.05）. Compared with before treatment，α-hydroxybutyrate dehydrogenase（α-HBDH），creatine kinase（CK），creatine kinase MB isoenzyme（CK-MB），Lactate Dehydrogenase（LDH），aspartate aminotransferase（AST），and cardiac troponin I（cTnI）were decreased after treatment，and these indexes in the study group were lower than those in control group 1 and control group 2；the levels of superoxide dismutase（SOD）were increased after treatment（ P<0.05），and the level of SOD in the study group was higher than those in control group 1 and control group 2（ P<0.05）. Conclusion:Hyperbaric oxygen combined with levosimendan can effectively improve vascular endothelial function and myocardial zymogram indexes in patients with sepsis myocardial injury.