艾司洛尔对老年脓毒症休克患者心功能、炎症指标及预后的影响

Effects of esmolol on cardiac function,inflammatory markers and prognosis in elderly patients with septic shock

目的:探讨艾司洛尔对改善老年脓毒症患者心功能、炎症指标及预后的影响。方法:选取2018年1-12月期间来苏州市立医院就诊的脓毒症患者64例作为研究对象,随机分为对照组与观察组,比较2组患者治疗前2 h、治疗后24 h心功能指标、临床疗效及不良反应情况。结果:与治疗前相比,2组患者治疗后左心室舒张早期最大血流(E)/二尖瓣心房收缩期最大流速(A)值均升高(P<0.05),心肌标志物[肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)、N-末端脑钠肽前体(NT-proBNP)]、炎症指标[白细胞介素(IL-1β、IL-6)、肿瘤坏死因子(TNF-α)]均有降低(P<0.05);与对照组比较,观察组E/A值升高幅度更加明显(P<0.05),心肌标志物(CK-MB、cTnI、NTproBNP)、炎症指标(IL-1β、IL-6、TNF-α)改善程度更加明显(P<0.05);治疗后,观察组总有效率96.88%(31/32)明显高于对照组的87.50%(28/32)(P<0.05);2组治疗过程中均未出现严重不良反应。结论:艾司洛尔可显著改善脓毒性休克患者心功能,保护心肌细胞,抑制炎性因子,改善患者预后,且安全性较好,值得临床推广。

Objective:This study was designed to investigate the effect of esmolol on improving cardiac function,inflammatory index and prognosis in elderly patients with sepsis.Methods:A total of 64 cases of sepsis patients who came to Suzhou Municipal Hospital from January 2018 to December 2018 were selected as research subjects,and randomly divided into control group and observation group.The patients in two groups were compared on clinical curative effect and adverse reaction condition before 2 h and 24 h after compared clinical effect and drug adverse reaction.Results:Compared with the index before treatment,left ventricular diastolic early maximum(E)/mitral valve atrial systolic blood flow velocity(A) value were increased(P <0.05),while myocardial markers [creatine kinase isoenzyme(CK-MB),troponin I(cTnI),N-terminal brain natriuretic peptide precursor(NT-proBNP)],inflammation index [interleukins(IL-1β,IL-6),tumor necrosis factor(TNF-α)] were lower(P <0.05).Compared with control group,E/A value of the observation group increased more obviously(P <0.05) than myocardial markers(CKMB,cTnI,NT-proBNP) and inflammation index(IL-1β,IL-6 and TNF-α).After treatment,the total effective rate of the observation group was96.88%(31/32),which was significantly higher than that of the control group 87.50%(28/32)(P <0.05).No serious adverse reactions occurred during the treatment of the two groups.Conclusion:Esmolol can significantly improve cardiac function in patients with septic shock,protect cardiomyocytes,inhibit inflammatory factors,and improve the prognosis of patients with good safety,which is worthy of clinical promotion.