美托洛尔对脓毒性休克患者心脏功能及预后影响的临床研究  

作　　者：徐前程 查磊[1] 陈尚华[1] 刘小彬[1] 

机构地区：[1]皖南医学院附属芜湖市第二人民医院,241000

出　　处：《浙江临床医学》2016年第9期1586-1588,共3页Zhejiang Clinical Medical Journal

摘　　要：目的评价美托洛尔对脓毒性休克患者心脏功能及预后的影响。方法早期目标导向治疗（EGDT）达标的脓毒性休克患者50例，分为观察组25例与对照组25例，观察组予以美托洛尔12．5mg鼻饲，2次，d，对照组使用生理盐水，观察两组患者治疗后心脏功能指标及机械通气时机、病死率等指标。结果观察组经治疗后NT_proBNP逐渐降低，与对照组比较，2d后各时间点明显降低（P〈O．05），观察组经治疗后每日液体需求量呈明显下降趋势，与对照组比较，2d、3d每日液体需求量明显降低（P〈O．05），对照组下降程度及速度均较观察组慢，4d后与1d比较明显下降（P〈O．05）；两组患者液体出量差异无统计学意义（P〉O．05）；观察组EVLWI经治疗后明显下降，3d后各时间点与1d及对照组比较，差异有统计学意义（P〈O．05），对照组EVLWI下降缓慢，5d后时间点与1d比较差异明显。观察组患者的ICU病死率、28d病死率、住院病死率、机械通气时间、住ICU病死率比对照组均有降低趋势，但差异均无统计学意义（P〉0．05），住院时间比对照组明显降低（P〈O．05）。结论鼻饲美托洛尔治疗脓毒性休克可以降低液体需要量、改善心脏功能、降低EVLWI，有降低住院时间、病死率、机械通气时间的趋势。Objective To observe the effect ofmetoprolol on cardiac function and clinical outcomes in patients with septic shock. Methods It was a prospective randomized controlled trial. A totally of 50 patients meeting the inclusion criteria and divided into two groups according to whether using metoprolol or not, each group contain 25 patients. Results The baseline was balance and comparable. There is a tendency of decrease of experimental group in NT-proBNP, Contrasted to control group, NT-proBNP reduced significantly after 2d （ P〈0.05 ） , There was a tendency of decrease of fluid intake in experimental group, Contrasted to control group, fluid intake reduced significantly at 2d, 3d （P〈0.05） .the fluid intake reduced slowly in control group and reduced obviously at 4d compared with ld （P〈0.05） , the output was not statistical difference in two groups （P〉0.05） ; There was a tendency of decrease of EVLWI in experimental group, and reduced significantly after 3d compared with ld, When contrasted to control group the EVLW! level were lower after 3d, but not at 7d, in control group the EVLWI reduced slowly compare with experimental group, and reduced significantly after 5d compared with ld; There was a tendency of decrease of experimental group in ICU mortality, 28days mortality, in-hospital mortality, mechanical ventilation time and length of ICU stay, but does not have statistical differences （ P〉0.05 ） .But the length of hospital stay in experimental group was shorter than control group （ P〈0.05 ） , Conclusions Metoprolol can reduce fluid intake and EVLWI, improve cardiac function.There was a tendency improve clinical outcomes.

关 键 词：脓毒性休克关托洛尔 心脏功能 临床预后 

分 类 号：R631.4[医药卫生—外科学]