脓毒症中抑制交感神经活性对心脏的影响  

Influence of depress sympathetic nerve activity on the heart in sepsis

作　　者：伍复年 许雪花[2] 黄露萍[2] 廖永玲[3] 刘子由[2] 温贤铭 

机构地区：[1]赣南医学院第一附属医院心脏重症监护室,江西赣州341000 [2]赣南医学院第一附属医院心胸外科,江西赣州341000 [3]赣南医学院第一附属医院心血管内科,江西赣州341000

出　　处：《中国当代医药》2015年第34期31-33,共3页China Modern Medicine

基　　金：江西省赣州市指导性科技计划项目(GZ2014ZSF043)

摘　　要：目的 探讨抑制交感神经活性对脓毒症患者心脏功能的影响。方法 选取2013年1月~2015年6月我院收治的84例脓毒症患者作为研究对象,按照随机数字法将其分为观察组与对照组,各42例。对照组仅单纯实施脓毒症的常规治疗措施,观察组在此基础上采用酒石酸美托洛尔片进行治疗,观察两组心脏功能的差异。结果治疗后,观察组的血压、左室壁厚度、心率、左室射血分数、N末端B型脑钠肽水平显著低于对照组,肌酸激酶同工酶显著高于对照组,差异有统计学意义（P〈0.05）。观察组的死亡率显著低于对照组,差异有统计学意义（P〈0.05）。结论 积极抗感染基础上给予β受体阻滞剂,可抑制脓毒症患者过度激活的交感神经活性,有效减轻心脏做功,降低心率,从而减轻心肌的损害,降低死亡率,值得推广应用。Objective To explore the influence of depress sympathetic nerve activity in cardiac function of patients with sepsis. Methods 84 patients with septic treated in our hospital from January 2013 to June 2015 were selected as research objects.According to a random number table,they were evenly divided into observation group and control group,with 42 eases in each group.In the control group,only conventional therapeutic measure on sepsis was used,while in the observation group,on the basis of the control group,metoprolol tartrate tablet was added.The difference of cardiac function in two groups was observed. ResultsThe blood pressure,left ventricular wall thickness,heart rate,left ventricu- lar ejection fraction and NT-proBNP level in observation group were significantly lower than those of control group,and the ereatine kinase isoenzyme in observation group was significantly higher than that of control group,the differences were significant between two groups （P〈0.05）.The mortality rate in observation group was also significantly lower than that of control group,the difference was significant between two groups （P〈0.05）. Conclusion On the basis of active anti-infection,application of [3-blocker can inhibit excessive activation of sympathetic nerve activity in patients with sepsis,and can effectively alleviate cardiac acting,reduce heart rate,and relieve myocardial damage,reduce of mortality rate, which is worth popularization and application.

关 键 词：脓毒症 交感神经活性 心脏功 Β受体阻滞剂 

分 类 号：R631[医药卫生—外科学]