【摘要】 目的 探讨静脉泵入艾司洛尔对脓毒症患者炎症反应及左心功能的影响。方法将89例脓毒症患者随机分为治疗组(42例)及对照组(47例),记录治疗前急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)、序贯器官衰竭评分(SOFA)。对照组给予常规治疗,治疗组在常规治疗基础上给予静脉持续泵入艾司洛尔[首剂500 mg,0.05 mg/(kg·min)],分别心脏超声测量两组用药后0、12、24、48 h心率(HR)、左室舒张末前后径(LVDD)、左室射血分数(LVEF)、二尖瓣环舒张期早期峰值速度(Ea)与舒张晚期峰值速度(Aa)比值(Ea/Aa),测定血浆肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)水平。结果 与对照组比较,治疗组12 h后TNF-α、IL-1β水平明显下降(P<0.05),HR明显减慢(P<0.05),Ea/Va明显升高(P<0.05),LVDD、LVEF差异无统计学意义(P>0.05)。结论 脓毒症患者存在左心功能障碍,艾司洛尔能下调脓毒症患者炎症反应,改善脓毒症患者左心舒张功能。更多还原

【Abstract】 Objective To investigate the changes of inflammatory response and Left ventricular function in sepsis patients treated with esmolo.Methods Eighty-nine patients with sepsis were randomly divided into control group(n = 47) and treatment group(n = 42).The acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score,sequential organ failure assessment(SOFE) score were recorded before treatment.Patients in control group were given conventional treatment,while patients in treatment group were given conventional treatment and esmolo injection(first-dose 500 mg, and then 0.05 mg/(kg ? min).Serum TNF-α and IL-1β levels were measured and the changes of HR,LVDD,LVEF,Ea,Aa and Ea/Aa were observed by echocardiography at 0,12,24 and 48 h of treatment.Results Compared with control group,esmolo injection for 12 h decreased serum TNF-α, IL-1β and HR and elevated Ea/Aa markedly(P < 0.05);but LVDD and LVEF were not difference between the two groups(P >0.05).Conclusion Left ventricular dysfunction always occurs in sepsis patients.Esmolol can down-regulate the inflammatory responses,and improve left ventricular diastolic function in patients with sepsis.更多还原