艾司洛尔联合连续血液净化治疗对感染性休克患者组织氧代谢及炎性因子水平的影响  

Effects of esmolol combined with CBP therapy on tissue oxygen metabolism and inflammatory factor levels in patients with septic shock

作　　者：唐燕平 李善敬 苏钟东 TANG Yanping;LI Shanjing;SU Zhongdong(Department of Emergency,the Second Affiliated Hospital of Guangdong Medical University,Zhanjiang 524000,Guangdong,China)

机构地区：[1]广东医科大学附属第二医院急诊科,广东湛江524000

出　　处：《右江医学》2023年第10期892-895,共4页Chinese Youjiang Medical Journal

摘　　要：目的探讨艾司洛尔联合连续血液净化(CBP)治疗感染性休克的临床效果及对机体组织氧代谢、炎性因子水平的影响。方法选取2019年1月—2021年1月广东医科大学附属第二医院急诊科收治的感染性休克患者68例,按随机数字表将其分为对照组(39例)与观察组(39例)。两组均接受常规治疗,对照组采用CBP治疗,于对照组基础上,观察组加用艾司洛尔治疗,持续治疗5~7 d。比较两组临床疗效、组织氧代谢指标、炎性因子水平及心功能指标。结果观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05);观察组治疗后中心静脉血氧饱和度(ScvO 2)高于对照组,血乳酸(Lac)低于对照组,差异有统计学意义(P<0.001);观察组治疗后白介素-1β(IL-1β)、降钙素原(PCT)水平和B型钠尿肽(BNP)、肌钙蛋白I(cTnI)低于对照组,差异有统计学意义(P<0.01)。结论艾司洛尔联合CBP可增强感染性休克治疗效果,减轻机体炎症反应,改善组织氧代谢,且具有心肌保护作用,可加快病情好转。Objective To investigate the clinical effect of esmolol combined with continuous blood purification(CBP)in the treatment of septic shock and its effect on tissue oxygen metabolism and inflammatory factor levels.Methods A total of 68 patients with septic shock admitted to the Emergency Department of the Second Affiliated Hospital of Guangdong Medical University from January 2019 to January 2021 were selected and divided into control group(39 cases)and observation group(39 cases)according to random number table.Both groups received conventional treatment,the control group were treated with CBP,and on the basis of the control group,the observation group were additionally treated with esmolol for 5-7 days.And then,clinical efficacy,tissue oxygen metabolism indexes,inflammatory factor levels and cardiac function indexes were compared between the two groups.Results The total effective rate of treatment in the observation group was higher than that in the control group,and difference was statistically significant(P<0.05).After treatment,central venous oxygen saturation(ScvO 2)in the observation group was higher than that in the control group,and blood lactate acid(Lac)was lower than that in the control group,and the difference was statistically significant(P<0.001).After treatment,the levels of interleukin-1β(IL-1β)and procalcitonin(PCT),B-type natriuretic peptide(BNP),and Troponin I(cTnI)in the observation group were lower than those in the control group,and difference was statistically significant(P<0.01).Conclusion Esmolol combined with CBP can enhance the therapeutic effect of septic shock,reduce body's inflammatory response,improve tissue oxygen metabolism,and has myocardial protective effect,which can accelerate the improvement of the condition.

关 键 词：感染性休克 艾司洛尔 连续血液净化 氧代谢 炎性因子水平 

分 类 号：R459.7[医药卫生—急诊医学]