脓毒症心肌抑制患者静脉泵入米力农联合艾司洛尔的短期疗效

发布时间：2018-03-14 09:08

本文选题：脓毒症　切入点：心肌抑制　出处：《实用医学杂志》2017年06期 　论文类型：期刊论文

【摘要】：目的:探讨米力农联合艾司洛尔对脓毒症心肌抑制患者血流动力学及心功能的影响。方法:选择2010年10月至2014年10月首都医科大学附属北京世纪坛医院重症医学科确诊为脓毒症患者,使用脉搏指示连续心排血量(PICCO)血流动力学检测评价血流动力学参数,将心脏指数CI2.2L/(min·m2)需应用正性肌力药物的的74例患者纳入本研究,并按照随机数字表法分为常规治疗组及米力农联合爱络组两组,每组37例。常规治疗组为A组(多巴酚丁胺组),B组(米力农联合艾司洛尔组)。治疗期间比较两组PiCCO及超声相关参数,并检测心肌酶(CK、CK-MB、MYO、cTnI)及ProBNP水平。结果:(1)与A组相比,B组治疗后3dCI、GEF明显增高。(2)与A组相比,B组治疗后3d左心室舒张早期/舒张晚期最大血流比值(E/A)、舒张期右室内径(RVD)差异均有显著性。(3)与A相比较,B组治疗后3dCK-MB、cTnI、ProB-NP均下降更为显著。结论:联合应用米力农及艾司洛尔,可使脓毒症心肌抑制患者心率减慢,射血分数增加,降低肺动脉压,减轻心肌损害,具有改善心脏功能及优化血流动力的作用。
[Abstract]:Objective: to investigate the effects of milrinone combined with esmolol on hemodynamics and cardiac function in patients with myocardial sepsis. Methods: from October 2010 to October 2014, we selected the critical medicine of Beijing Shijitan Hospital affiliated to Capital Medical University. The patient was diagnosed with sepsis. The hemodynamic parameters were evaluated by pulse indicator continuous cardiac output (PICCO) hemodynamic test. 74 patients with cardiac index (CI2.2L/(min 路m2) who needed positive inotropic drugs were included in the study. According to the method of random digital table, they were divided into two groups: routine treatment group and milrinone combined with Ailo group. There were 37 cases in each group: group A (dobutamine group) and group B (milrinone combined with esmolol group). The PiCCO and ultrasonic parameters were compared between the two groups during the treatment. Compared with group A, the level of CK-MBN MYOOcTnI) and ProBNP were measured. Results compared with group A, the level of CK-MBN MyOcTnI was significantly higher than that of group A on the 3rd day after treatment. (2) compared with group A, the ratio of left ventricular early diastolic early diastolic to late diastolic maximum blood flow ratio E / A and right ventricular diameter in group A were significantly higher than those in group A and group A on the 3rd day after treatment, and the right ventricular diameter in diastolic phase was lower than that in group A. Compared with group A, the decrease of CK-MBN cTnInProB-NP in group B was more significant than that in group A. conclusion: combination of milrinone and esmolol is more significant than that of group A. It can slow down heart rate, increase ejection fraction, decrease pulmonary artery pressure, reduce myocardial damage and improve cardiac function and blood flow.
【作者单位】：首都医科大学附属北京世纪坛医院重症医学科;
【基金】：首都医科大学附属北京世纪坛医院院内青年课题(编号:2011-Q03) 北京市自然科学基金资助项目(编号:7123219)100038
【分类号】：R459.7

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