早期应用β受体阻滞剂对脓毒症患者血浆炎症因子及心肌损伤发生率的影响  

The influences of early application ofβblocker on serum inflammato-ry factors and occurrence of heart injury in patients with sepsis

作　　者：王滨[1] 张建洁[2] 路桂杰 孔继昌[1] 董红[4] WANG Bin;ZHANG Jianjie;LU Guijie;KONG Jichang;DONG Hong(Departemnt of Critical Care Medicine,General Hospital of Huabei Oilfield,Renqiu Hebei 062552,China)

机构地区：[1]华北石油管理局总医院重症医学科,河北任丘062552 [2]华北石油管理局总医院妇产科,河北任丘062552 [3]华北石油管理局井下医院检验科,河北任丘062552 [4]华北石油管理局总医院骨科,河北任丘062552

出　　处：《中国急救复苏与灾害医学杂志》2021年第8期907-910,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：河北省卫生健康委员会医学会科技计划项目(编号:20201251)。

摘　　要：目的探究早期应用β受体阻滞剂对脓毒症患者血浆相关炎症因子的影响,以及患者发生心肌损伤的相关性和在华北石油管理局总医院治疗的院内早期结果。方法回顾性分析92例脓毒症患者病例,根据药物使用情况将患者分为β受体阻滞剂治疗组(治疗组)和对照组。两组患者入院后均采取脓毒症早期目标导向治疗,对照组患者治疗相比组患者多应用β受体阻滞剂。取所有患者入院治疗后3 d、7 d静脉血液,采用ELISA法测定患者不同治疗时间点肿瘤坏死因子α(TNF-α),白细胞介素-6(IL-6),白细胞介素-1β(IL-1β)的浓度,根据患者病情,收集病程中心脏功能指标,判定两组患者脓毒症心肌损伤情况,并评价患者院内死亡率和两组患者生存曲线。结果治疗组患者在入院3、7 d时血浆中TNF-α、IL-6、IL-1β均显著低于对照组(P<0.05)。治疗组患者与对照组患者在院内死亡率上无显著差异,但是治疗组患者心肌损伤发生率显著低于对照组患者(P<0.05)。结论早期应用β受体阻滞剂可以降低脓毒症患者相关血浆炎症因子的水平,降低心肌损伤程度,减少脓毒症心肌病发生率。Objective To explore the effect of early application ofβblockers on plasma related inflammatory factors in patients with sepsis,as well as the correlation of patients with myocardial injury and the early results in our hospital.Methods 92 sepsis patients'clinical data were collected to retrospectively analyze.All patients were divided into two groups based on the therapy,which were theβblocker group(treatment group)and the control group.All patients were received the early goal-directed therapy for sepsis.Compared to the patients of control group,βblocker were utilized in the treatment group.Peripheral blood samples of patients were collected at the time of 3 day and 7 day after receiv⁃ing treatment.The concentrations of tumor necrosis factorα(TNF-α),Interleukin-6(IL-6)and Interleukin-1β(IL 1β)in patients serum were tested via ELISA method.And based on the clinical records,the occurrence of cardiac inju⁃ry,the in-hospital mortality and survival curves were made to analyzed.Results There was no significant difference be⁃tween the treatment group and control group in in-hospital mortality.And significant differences were observed in the concentrations of patient serums TNF-α、IL-6、IL-1βat 3 day and 7 day after receiving treatment.The occurrence of cardiac injury also existed significant difference between two groups.Conclusions Early application ofβblocker in sepsis therapy can effectively decrease the levels of relative serum inflammatory factors,and it also can decrease the oc⁃currence of cardiac injury in sepsis.

关 键 词：脓毒症 Β受体阻滞剂 炎症因子 心肌损伤 

分 类 号：R541.6[医药卫生—心血管疾病]