發(fā)布時間：2018-03-14 09:08

  本文選題：膿毒癥　切入點：心肌抑制　出處：《實用醫(yī)學雜志》2017年06期 　論文類型：期刊論文

【摘要】：目的:探討米力農(nóng)聯(lián)合艾司洛爾對膿毒癥心肌抑制患者血流動力學及心功能的影響。方法:選擇2010年10月至2014年10月首都醫(yī)科大學附屬北京世紀壇醫(yī)院重癥醫(yī)學科確診為膿毒癥患者,使用脈搏指示連續(xù)心排血量(PICCO)血流動力學檢測評價血流動力學參數(shù),將心臟指數(shù)CI2.2L/(min·m2)需應用正性肌力藥物的的74例患者納入本研究,并按照隨機數(shù)字表法分為常規(guī)治療組及米力農(nóng)聯(lián)合愛絡組兩組,每組37例。常規(guī)治療組為A組(多巴酚丁胺組),B組(米力農(nóng)聯(lián)合艾司洛爾組)。治療期間比較兩組PiCCO及超聲相關(guān)參數(shù),并檢測心肌酶(CK、CK-MB、MYO、cTnI)及ProBNP水平。結(jié)果:(1)與A組相比,B組治療后3dCI、GEF明顯增高。(2)與A組相比,B組治療后3d左心室舒張早期/舒張晚期最大血流比值(E/A)、舒張期右室內(nèi)徑(RVD)差異均有顯著性。(3)與A相比較,B組治療后3dCK-MB、cTnI、ProB-NP均下降更為顯著。結(jié)論:聯(lián)合應用米力農(nóng)及艾司洛爾,可使膿毒癥心肌抑制患者心率減慢,射血分數(shù)增加,降低肺動脈壓,減輕心肌損害,具有改善心臟功能及優(yōu)化血流動力的作用。
[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.
【作者單位】： 首都醫(yī)科大學附屬北京世紀壇醫(yī)院重癥醫(yī)學科;
【基金】：首都醫(yī)科大學附屬北京世紀壇醫(yī)院院內(nèi)青年課題(編號:2011-Q03) 北京市自然科學基金資助項目(編號:7123219)100038
【分類號】：R459.7

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