感染性休克患者心脏及微循环的功能变化与β受体阻滞剂的血流动力学效应  

Functional changes of heart and microcirculation in patients with septic shock and analysis of the hemodynamic effects of beta blockers

作　　者：孙志宝[1] 安庆华[1] 郑玉明[1] 齐凯[2] 程悦[2] 

机构地区：[1]滨州医学院附属滨州市人民医院急诊科,山东滨州256610 [2]滨州市邹平县精神卫生中心内科,山东滨州256218

出　　处：《中华医院感染学杂志》2016年第7期1528-1530,共3页Chinese Journal of Nosocomiology

基　　金：山东省医药卫生科技计划基金资助项目(2014WS0195)

摘　　要：目的探讨β受体阻滞剂在改善心脏及微循环功能的作用以及对血流动力学参数的影响,为临床更好的使用β受体阻滞剂治疗感染性休克提供参考。方法选取2012年3月-2014年2月医院81例感染性休克患者,随机分为观察组41例和对照组40例;对照组采用常规体液复苏的治疗方法,观察组在此基础上采用β受体阻滞剂的治疗方法,比较两组患者血流动力学指标及组织氧合指数参数,数据采用SPSS 17.0软件进行统计分析。结果观察组患者治疗后心率(HR)、心脏指数(CI)显著低于对照组;每搏输出量指数(SVI)显著高于对照组,差异有统计学意义(P<0.05);两组患者各时间点中心静脉血氧饱和度(ScvO2)比较差异无统计学意义,说明β受体阻滞剂有效的降低了血乳酸值。结论β受体阻滞剂可以改善心室顺应性以及舒张功能,血流动力学参数有所变化,提高组织灌注水平,可作为临床治疗感染性休克的有效手段之一。OBJECTIVE To investigate the effect of beta blockers in improving the function of the heart and microcirculation and the influence of the parameters of the blood flow so as to provide references for using beta blockers to cure septic shock in clinical practice.METHODS Totally 81 patients with septic shock in our hospital from Mar.2012 to Feb.2014 were selected and these patients were randomly divided into observation group（41cases）and control group（40cases）.The control group was treated with routine fluid resuscitation,and on the basis of this,the observation group was treated with beta blockers.The hemodynamic parameters and tissue oxygenation index were measured in two groups.All data were statistically analyzed by SPSS 17.0software.RESULTS The heart rate（HR）and cardiac index（CI）of the observation group were significantly lower than those in the control group,and the stroke volume index（SVI）was significantly higher than that in the control group（P〈0.05）.There was no significant difference between the central venous oxygen saturation（ScvO2）of the two groups at each time point.It showed that beta blockers were effective in reducing the blood lactate levels.CONCLUSIONBeta blockers can improve the ventricular compliance and diastolic function,and the hemodynamic parameters can be changed to improve tissue perfusion level,which can be used as an effective method for clinical treatment of septic shock.

关 键 词：Β受体阻滞剂 感染性休克 血流动力学 

分 类 号：R459.7[医药卫生—急诊医学]