β1-受体阻滞剂控制心率对感染性休克患者血流动力学和预后的影响

刘振兴; 白祥琰; 李维; 桂峰; 艾芬; 汪一帆

doi:10.13201/j.issn.1009-5918.2017.07.012

β1-受体阻滞剂控制心率对感染性休克患者血流动力学和预后的影响

- 华中科技大学同济医学院附属武汉中心医院急诊科(武汉, 430014)

详细信息

通讯作者: 汪一帆, E-mail:15926432206@126.com

中图分类号: R459.7

收稿日期: 2017-05-02

The effect of heart rate control of β1-Receptor Antagonists on Hemodynamics and prognosis in patients with septic shock

- Department of Emergency, Wuhan Central Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, China

More Information

Corresponding author: WANG Yifan, E-mail: 15926432206@126.com

Received Date: 02 May 2017

摘要

摘要: 目的:探讨对感染性休克患者应用β1-受体阻滞剂控制心率对血流动力学以及预后的影响。方法:选取2012-01-2016-10我院重症监护病房收治的80例感染性休克患者为研究对象,随机分为对照组和观察组,每组40例。对照组给予常规抗感染性休克治疗,观察组在此基础上给予静脉注射盐酸艾司洛尔注射液。记录比较2组治疗前(T1)及治疗后24 h(T2)、48 h(T3)、72 h(T4)的各项血流动力学指标、左室射血分数(LVEF)、左室舒张末期直径(LVEDD)及E峰与A峰比值(E/A),并对比2组住院期间的并发症发生率及病死率。结果:观察组心率在用药后明显下降,在24 h、48 h、72 h时均低于对照组(P<0.05);2组MAP、SpO₂比较,差异无统计学意义。治疗前2组患者心脏功能指标比较差异无统计学意义;治疗后观察组LVEDD、LVEF与E/A均高于对照组,差异具有统计学意义(P<0.05)。观察组急性肾损伤、急性呼吸窘迫综合症(ARDS)的发生率均低于对照组(P<0.05),此外观察组病死率为52.5%,显著低于对照组的85.0%,差异具有统计学意义(P<0.05)。结论:感染性休克患者使用β1-受体阻滞剂,可有效控制心率,改善心室的顺应性以及舒张功能,提高组织灌注水平,减轻对脏器的损伤,改善患者预后,因此可作为临床治疗感染性休克的有效药物选择之一。
- β1-受体阻滞剂 /
- 心率 /
- 感染性休克 /
- 血流动力学 /
- 预后
Abstract: Objective:To investigate the effect of heart rate control of β1- receptor antagonists on hemodynamics and prognosis in patients with septic shock.Method:Eighty patients with septic shock admitted to intensive care unit in our hospital from January 2012 to October 2016 were selected as study subject.The control group was given conventional anti-septic shock treatment;on this basis,the observation group was given intravenous injection of esmolol hydrochloride.Various haemodynamics index,left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter (LVEDD) and the specific value of E peak and A peak regarding prior treatment (T1) and post-treatment 24 h(T2)、48 h(T3)、72 h(T4) in two groups with complication and case fatality rate during hospitalization in two groups recorded and compared.Result:The HR in the observation group was significantly decreased after treatment and it was all lower than the control group(P<0.05)in the 24 h,48 h and 72 h;There was no significant difference for MAP、SpO₂ in two groups.The LVEDD,LVEF and E/A in observation group were all higher than those in the control group,with significant difference (P<0.05).The occurrence rate of acute kidney injury and acute respiratory distress syndrome (ARDS) in observation group was all lower than those in control group (P<0.05).Besides,the death rate of observation group was 52.5%,which was significantly lower than 85.0% in control group so that the difference was of statistic significance.Conclusion:Patients with septic shock who apply β1- receptor antagonist can effectively control the heart rate,improve ventricular compliance & diastolic function,increase tissue perfusion level,reduce viscera damage and improve the patients' prognosis so that it can be served as one of the effective drugs for the treatment of septic shock.
- β1-Receptor Antagonist /
- Heart Rate /
- Septic Shock /
- Hemodynamics /
- Prognosis

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