美托洛尔对感染性休克早期心肌损伤患者血流动力学的影响

发布时间：2018-06-07 02:34

本文选题：美托洛尔 + 感染性休克　；参考：《中国呼吸与危重监护杂志》2016年01期

【摘要】：目的探讨美托洛尔对感染性休克早期心肌损伤患者血流动力学的影响。方法前瞻性选择2014年3月至2015年2月在南方医科大学附属小榄医院ICU住院的22例感染性休克早期合并心肌损伤患者作为研究对象。通过中心静脉注射美托洛尔使心率下降20%,并持续静脉维持6 h,动态连续收集血流动力学及氧代谢参数建立数据库。结果给药后1、3和6h患者心率分别为(98±18)、(95±16)和(92±18)次/min,比给药前心率(125±28)次/min明显降低(P0.05)。给药后1、3和6 h患者心排指数分别为(3.2±1.5)、(3.3±1.9)、(3.3±1.6)L·min~(-1)·m~(-2),比给药前(3.9±2.5)L·min~(-1)·m~(-2)显著降低(P0.05)。给药前后平均动脉压、中心静脉压、肺动脉嵌顿压、肺循环阻力指数、体循环阻力指数、每搏量指数等均无显著变化(P0.05)。给药后3和6h血乳酸水平为(9.8±4.1)和(8.1±3.6)mmol/L,与治疗前(13.4±5.2)mmol/L比较差异有统计学意义(P0.05)。治疗前后混合静脉血氧饱和度比较差异无统计学意义(P0.05)。结论美托洛尔能够有效降低感染性休克早期心肌损伤患者的心率和心排出量,但对循环功能和全身组织灌注无明显影响。
[Abstract]:Objective to investigate the effect of metoprolol on hemodynamics in patients with early myocardial injury after septic shock. Methods from March 2014 to February 2015, 22 patients with early septic shock complicated with myocardial injury in ICU hospital affiliated to Southern Medical University were selected as study subjects. Metoprolol was injected into the central vein to decrease the heart rate by 20% and to maintain the vein for 6 h. The hemodynamics and oxygen metabolism parameters were collected dynamically and continuously to establish a database. Results the heart rate was 95 卤16 and 92 卤18 / min at 1h and 6h, respectively, which was significantly lower than that before administration (P 0.05 / min). The cardiac output index of the patients at 1h and 6h after administration was 3.3 卤1.9L / min and 3.3 卤1.6L / min respectively, which was significantly lower than that before administration (3.9 卤2.5L / L / min / 1) / (P _ (0.055N). There were no significant changes in mean arterial pressure, central venous pressure, pulmonary artery incarceration pressure, pulmonary vascular resistance index, systemic resistance index and stroke volume index before and after administration. The blood lactate levels were 9.8 卤4.1) and 8.1 卤3.6 mmol / L at 3 and 6 hours after administration, which was significantly higher than that before treatment with 13.4 卤5.2)mmol/L. There was no significant difference in oxygen saturation of mixed vein before and after treatment (P 0.05). Conclusion metoprolol can effectively reduce heart rate and cardiac output in patients with early myocardial injury in septic shock, but has no effect on circulatory function and systemic tissue perfusion.
【作者单位】：南方医科大学附属小榄医院重症医学科;
【分类号】：R459.7

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