艾司洛尔联合早期目标导向治疗对脓毒症心肌病患者的影响  

Effect of Esmolol Combined with Early Goal Directed Therapy on Septic Cardiomyopathy Patients

作　　者：卓秀明[1] ZHUO Xiuming(Fujian Medical University Provincial College of Clinical Medicine,Fuzhou 350013,China)

机构地区：[1]福建医科大学省立临床医学院(福建省立医院),福建福州350013

出　　处：《中外医学研究》2023年第36期51-54,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨艾司洛尔联合早期目标导向治疗(EGDT)对脓毒症心肌病患者的影响。方法:回顾性分析2021年1月—2022年12月福建医科大学省立临床医学院收治的96例脓毒症心肌病患者的资料。根据不同治疗方法将其分为对照组(n=48)和观察组(n=48)。两组均给予常规治疗,对照组给予EGDT,观察组在对照组基础上给予艾司洛尔。比较两组治疗前、治疗24 h后炎症因子、心功能指标、循环指标,不良反应及病死率。结果:治疗24 h后,观察组白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平均低于对照组,差异有统计学意义(P<0.05)。治疗24 h后,观察组肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白Ⅰ(cTnⅠ)、心肌肌钙蛋白T(cTnT)水平均低于对照组,差异有统计学意义(P<0.05)。治疗24 h后,观察组平均动脉压(MAP)高于对照组,心率(HR)低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。观察组28 d病死率低于对照组,差异有统计学意义(χ^(2)=4.360,P=0.037)。结论:艾司洛尔联合EGDT可明显减轻脓毒症心肌病患者炎症反应及心肌损害,提高心功能,降低病死率,且不增加不良反应。Objective:To explore the effect of Esmolol combined with early goal directed therapy(EGDT)on septic cardiomyopathy patients.Method:The data of 96 patients with septic cardiomyopathy admitted to the Fujian Medical University Provincial College of Clinical Medicine from January 2021 to December 2022 were retrospectively analyzed.They were divided into control group(n=48)and observation group(n=48)according to different treatment methods.Both groups were given conventional treatment,the control group was given EGDT,and the observation group was given Esmolol based on the control group.Inflammatory factors,cardiac function indexes,circulatory indexes before treatment and after 24 h of treatment,adverse reactions and mortality were compared between the two groups.Result:After 24 h of treatment,the levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).After 24 h of treatment,the levels of creatine kinase isoenzyme(CK-MB),cardiac troponin I(cTnI)and cardiac troponin T(cTnT)in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).After 24 h of treatment,the mean arterial pressure(MAP)of the observation group was higher than that of the control group,heart rate(HR)was lower than that of the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The 28 d mortality of the observation group was lower than that of the control group,and the difference was statistically significant(X^(2)=4.360,P=0.037).Conclusion:Esmolol combined with EGDT can significantly reduce inflammation reaction and myocardial damage in patients with septic cardiomyopathy,improve cardiac function,reduce mortality,and do not increase adverse reactions.

关 键 词：艾司洛尔 早期目标导向治疗 脓毒症心肌病 炎症反应 心肌损害 

分 类 号：R459.7[医药卫生—急诊医学] R542.2[医药卫生—治疗学]