舒张压对脓毒性休克进展预测价值及治疗指导的研究进展

Clinical research progress of diastolic blood pressure in predicting the progression and guiding the treatment of septic shock

部分脓毒性休克患者即使按照拯救脓毒症运动指南进行积极的液体复苏,平均动脉压达标(≥65 mmHg,1 mmHg=0.133 kPa)时仍存在较低的舒张压。而舒张压作为反映血管张力及左心室灌注压力指标,舒张压的降低与病情严重程度及预后密切相关。本文通过查阅相关研究,从脓毒性休克舒张压降低的病理生理机制、舒张压对脓毒性休克发生发展、器官功能障碍和预后的预测价值以及指导早期血管活性药物使用等方面进行综述,以期为重症医师救治脓毒性休克患者提供更多的参考。

Even if patients with septic shock were actively resuscitated in accordance with the guidelines of the surviving sepsis campaign bundle,some patients still had low diastolic blood pressure with a mean arterial pressure≥65 mmHg.As an indicator of vascular tension and left ventricular perfusion pressure,diastolic blood pressure reduction is closely related to the disease severity and prognosis of septic shock patients.In this manuscript,we reviewed the pathophysiological mechanism of blood pressure reduction in septic shock,the predictive value of diastolic blood pressure on the occurrence and development of septic shock,organ dysfunction and prognosis,as well as the guidance for the early use of vasopressor,providing more information for ICU physicians in management of septic shock.