【摘要】 目的观察早期使用β受体阻滞剂对全身炎症反应综合征(SIRS)患者预后的影响。方法选择2011年1—12月北京大学人民医院重症监护病房收治的患者72例,根据患者的临床表现判断其有无SIRS,并根据治疗方案将患者分为治疗组41例,对照组31例。治疗组在入院后48 h内使用β受体阻滞剂,而对照组不使用β受体阻滞剂,观察两组患者在入院时和入院第3、7天APACHEⅡ评分、尿量和病死率等结果。结果两组患者在入院时和入院第3天APACHEⅡ评分差异无统计学意义(P值分别为0.945和0.124),在第7天时,治疗组的评分显著低于对照组(P=0.001)。两组入院时和入院第3天尿量/入量比值差异无统计学意义(P值分别为0.086和0.067),入院第7天治疗组尿量/入量比值显著高于对照组(P=0.006)。住院期间治疗组病死率明显低于对照组(P=0.001)。结论SIRS患者早期给予β受体阻滞剂可在入院第7天明显降低APACHEⅡ评分,改善患者症状,改善患者预后,降低病死率;而且在维持正常血压的前提下,不影响重要器官的灌注。更多还原

【Abstract】 Objective To observe the influence of β-blocker in patients with systemic inflammatory response syndrome( SIRS) at early period. Methods A total of 72 patients admitted in the Critical Care Unit of our hospital from January 1 to December 31,2011 were analyzed. SIRS was diagnosed by clinical features,and the patients were divided into two groups. The patients in treatment group( n = 41) received β-blocker therapy 48 hours after admission,and the rest of the patients( n =31) served as controls. The scores of APAHE Ⅱ,urine volume and mortality were analyzed. Results There were no statically differences in the age and usage rates of mechanical ventilation between the two groups. The APACHE Ⅱ scores were not significantly different between the groups in 24 hours and at the third day after admission( P = 0. 945,0. 124,respectively). However,the score was significantly lower in the treatment group than that in the control group at the seventh day( P = 0. 001). The ratios of urine to daily intake had no statistical difference between two groups in 24 hours and at the third day after admission( P = 0. 086,0. 067,respectively),but the ratio in the treatment group was higher than that in the control group at the seventh day( P = 0. 006). The mortality was significantly lower in the treatment group than that in the control group( P = 0. 001). Conclusion Treatment of SIRS patients with β-blocker at early period could decrease the APACHE Ⅱ scores at the seventh day after admission,ameliorate the symptoms of patients,improve the prognosis and reduce the mortality. It will also not influence the infusion of important organs while the blood pressure is maintained normal.更多还原