右美托咪定联合倍他乐克拮抗交感活性亢进的临床研究  

Clinical study on antagonistic sympathetic activity of dexmedetomidine combined with metoprolol

作　　者：方志成[1] 郑翔[1] 盛春风[1] 

机构地区：[1]湖北医药学院附属太和医院重症医学科,湖北十堰442000

出　　处：《实用药物与临床》2013年第9期811-813,共3页Practical Pharmacy and Clinical Remedies

摘　　要：目的评价右美托咪定联合倍他乐克对交感活性亢进的抑制作用。方法 97例交感电风暴患者分为对照组(C组)、倍他乐克组(M组)、右美托咪定组(D组)、右美托咪定+倍他乐克联合治疗组(M+D组),持续心电监护评估交感电风暴发生,检测血浆去甲肾上腺素(NE)、肾上腺素(E),评估交感活性,脉搏指示连续心输出量监测(PiCCO),以心输出量(CO)、心指数(CI)、血管外肺水(EVLWI)及血浆脑型利钠肽(BNP)评估心功能。结果与其他组相比,联合治疗组交感电风暴发生率最低(P<0.05),血浆NE、E明显下降(P<0.05),交感活性最低,血流动力学CO、CI、EVLWI及血浆BNP明显下降(P<0.05),心功能恢复最好。结论右美托咪定联合倍他乐克可有效地抑制交感活性,治疗交感电风暴效果最佳。Objective To evaluate the effects of dexmedetomidine combined with metoprolol on the inhibition sympathetic activity of hyperfunction.Methods 97 cases of sympathetic electrical storm were divided into control group（group C）,metoprolol group（group M）,dexmedetomidine group（group D） and dexmedetomidine ＋ metoprolol group（group M ＋ D）,all of the patients were given continuous ECG monitoring to assess the occurrence of sympathetic electrical storm; plasma norepinephrine（NE）,adrenaline（E） were evaluated to assess the sympathetic activity; pulse indicator continuous cardiac output monitoring（PiCCO） method was used; the hemodynamic changes of cardiac output（CO）,cardiac index（CI）,extra vascular lung water（EVLWI） and plasma brain natriuretic peptide（BNP） were evaluated to assess the cardiac function.Results In group M ＋ D,compared with the other groups,the sympathetic electrical storm was the lowest（P0.05）,and the NE and E decreased significantly（P0.05）,the sympathetic activity was the lowest,the CI,CO,EVLWI and plasma BNP decreased obviously（P0.05）,the cardiac function was recovered.Conclusion Dexmedetomidine combined with metoprolol can effectively restrain the sympathetic activity,it has good effect on sympathetic electrical storm.

关 键 词：右美托咪定 交感风暴 倍他乐克 

分 类 号：R614[医药卫生—麻醉学]