艾司洛尔对重症肺炎患者心肌损伤和代谢功能的影响研究  

Research on the effect of esmolol on myocardial injury and metabolic function in patients with severe pneumonia

作　　者：张雯齐 李金玉 米孟琦 冯凯 刘建 部璇 程爱斌 ZHANG Wenqi;LI Jinyu;MI Mengqi;FENG Kai;LIU Jian;BU Xuan;CHENG Aibin(School of Clinical,North China University of Science and Technology,Tangshan 063000,China)

机构地区：[1]华北理工大学临床医学院,河北省唐山市063000 [2]华北理工大学附属医院重症医学科

出　　处：《中国煤炭工业医学杂志》2024年第6期586-590,共5页Chinese Journal of Coal Industry Medicine

基　　金：河北省中医药管理局科研计划项目(编号:2018184)

摘　　要：目的 探讨艾司洛尔对重症肺炎患者心肌损伤和代谢功能的影响。方法 本研究以2023年6月—2024年6月在华北理工大学附属医院重症医学科就诊的96例重症肺炎患者为研究对象,采用随机数字表法随机分为对照组(n=48)与治疗组(n=48)。对照组患者依据重症肺炎的标准化治疗指南给予常规的临床治疗措施,治疗组患者在给予上述常规治疗的基础上,通过静脉泵入的方式给予艾司洛尔注射液;记录两组患者年龄、性别、APACHEⅡ评分,入院当天、入院第3天及入院第5天时的心率、舒张压、动脉氧分压(P_(a)O_(2))、氧合指数、血乳酸、白蛋白、肌酸激酶同工酶(CK-MB)、D-二聚体的表达水平,记录ICU住院天数及ICU住院病死率,并比较两组研究对象间的差异。结果 两组研究对象性别、年龄、APACHEⅡ评分一般资料比较,差异无统计学意义(P>0.05);重复测量方差分析结果显示,两组患者心率、白蛋白水平存在时间效应、组间效应及交互效应(P<0.05),治疗组各时间点心率显著低于对照组(P<0.05),治疗组各时间点白蛋白水平显著高于对照组(P<0.05)。结论 艾司洛尔能够降低重症肺炎患者的心率从而减轻心肌损伤,且能够减少白蛋白分解以改善高分解代谢。Objective To investigate the impact of esmolol on myocardial injury and metabolic function in patients with severe pneumonia.Methods This study enrolled 96 patients with severe pneumonia admitted to the Department of Critical Care Medicine at the Affiliated Hospital of North China University of Science and Technology between June 2023 and June 2024.The patients were randomly divided into a control group(n=48)and a treatment group(n=48).The control group received conventional clinical treatment according to standardized treatment guidelines for severe pneumonia,while the treatment group received intravenous esmolol injection via a pump in addition to the aforementioned conventional treatment,aiming to further explore its therapeutic effects.Data on age,gender,APACHE II scores,heart rate,diastolic blood pressure,arterial oxygen partial pressure(P_(a)O_(2)),oxygenation index,blood lactate levels,albumin levels,creatine kinase isoenzyme MB(CK-MB)levels,D-dimer levels on the day of admission,the 3rd day of admission,and the 5th day of admission were recorded.The length of ICU stay and ICU mortality were also documented,and differences between the study groups were compared.Results Comparison of general information including gender,age and APACHE II scores between the two study groups showed no statistically significant difference(P>0.05).Results from repeated measures ANOVA indicated that there were significant time effects,between-group effects,and interaction effects for both heart rate and albumin levels in the two patient groups(P<0.05).Specifically,the heart rate at various time points in the treatment group was significantly lower than that in the control group(P<0.05).Additionally,the albumin levels at various time points in the treatment group were significantly higher than those in the control group(P<0.05).Conclusion This study suggests that esmolol can effectively reduce the heart rate of patients with severe pneumonia,thereby alleviating myocardial injury.Furthermore,esmolol can decrease albumin catabolism

关 键 词：重症肺炎 艾司洛尔 Β受体阻滞剂 病死率 

分 类 号：R563.1[医药卫生—呼吸系统]