美托洛尔对感染性休克合并心肌损伤患者临床预后的影响

池锐彬; 邹启明; 李超锋; 叶铨秋; 梁美华; 周卉芬

doi:10.13201/j.issn.1009-5918.2019.07.016

美托洛尔对感染性休克合并心肌损伤患者临床预后的影响

- 南方医科大学附属小榄医院重症医学科(广东中山, 528415)
基金项目:
中山市医学科研项目(No:2014A020182)

详细信息

通讯作者: 池锐彬,E-mail:CRB77970922@163.com

中图分类号: R459.7

收稿日期: 2018-12-19

Influence of metoprolol on clinical prognosis in septic shock patients with myocardial injury

- Department of Critical Care Medicine, Xiaolan Hospital of Southern Medical University, Zhongshan, Guangdong, 528415, China

More Information

Corresponding author: CHI Ruibin, E-mail: CRB77970922@163.com

Received Date: 19 December 2018

摘要

摘要: 目的: 分析感染性休克早期合并心肌损伤患者的临床预后情况,初步探讨美托洛尔对其临床预后的影响。方法: 回顾分析2014-03—2017-07期间在我院ICU住院的42例感染性休克合并心肌损伤患者的临床资料及预后情况,根据治疗初期是否使用美托洛尔治疗分为美托洛尔组和非美托洛尔组,比较两组患者的一般资料、感染来源、临床预后、心脏标志物、住院病死率及28d病死率。根据临床预后情况分为28d死亡组和28d存活组,比较两组间患者救治初期的临床危重度、心脏标志物以及美托洛尔使用情况等。结果: ①整个研究人群住院病死率为28.5%,28d病死率为35.7%。美托洛尔组的住院病死率和28d病死率(分别为22.7%和35.0%)低于非美托洛尔组(分别为27.3%和45.0%),但差异无统计学意义(P>0.05)。②28d死亡组的APACHEⅡ评分、N端脑钠肽前体(NT-pro-BNP)及高敏肌钙蛋白T(cTNT)均明显高于28d存活组[分别为(28±5)vs.(21±3)分,(1760±370)vs.(1250±230)pg/ml和(323±75)vs.(228±56)pg/ml],差异有统计学意义(P<0.05)。③与28d死亡组比较,28d存活组在初始治疗中采用美托洛尔方案的患者数更多,差异有统计学意义(P<0.05)。结论: 感染性休克合并心肌损伤患者病情危重,NT-proBNP、cTNT水平明显升高者预后更差,美托洛尔可能降低其住院病死率和28d病死率。
- 感染性休克 /
- 心肌损伤 /
- 美托洛尔 /
- 心脏标志物 /
- 预后
Abstract: Objective: To analyze the clinical prognosis of septic shock patients with myocardial injury,and to explore the effect of metoprolol on its clinical prognosis.Method: In this study,we retrospectively analysed the clinical data of 42 septic shock patients with myocardial injury,who had been admitted to the adult mixed ICU of Xiaolan Hospital of Southern Medical University during March 2014 to July 2017.The patients were divided into metoprolol group and non-metoprolol group according to the therapeutic schemes,meanwhile divided into 28 d death group and 28 dsurvival group according to the clinical outcomes.Clinical severity,the therapy of metoprolol,heart biomarkers and other index were collected to establish database and compared in different groups.Result: In this cohort,in-hospital mortality was 28.5% and 28 dmortality was 35.7%,which were lower in metoprolol group than non-metoprolol group(P>0.05).The levels of NT-pro-BNP,cTNT and APACHEⅡ score were significantly higher in 28 ddeath group than 28 dsurvival group[(28±5)&(21±3)score,(1760±370)&(1250±230),(323±75)&(228±56)pg/ml,all P<0.05].Compared with the 28 ddeath group,more patients in the28 dsurvival group adopted the therapy of metoprolol in the early stage of septic shock(P<0.05).Conclusion: Septic shock with myocardial injury is a severe disease,in which significant elevation in NT-proBNP and cTNT levels indicates a worse prognosis.Metoprolol may reduce the in-hospital mortality and 28-day mortality in these patients,and improve their clinical outcomes.
- septic shock /
- myocardial injury /
- metoprolol /
- biomarker /
- prognosis

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