摘要
Abstract
Objective To investigate the effect of early phase esmolol treatment to prevent sepsis induced myocardial dysfunction(SIMD)and improve deceleration capacity(DC)in patients with sepsis.Methods Ninety sepsis patients were enroll from Nanjing integrated Chinese and Western Medicines Hospital from January.2015 to April,2017.All the patients were divided into two groups:esmolol group(n=40)and control group(n=50).NT-proBNP,cTnI,cardiac ultrasound and DC were compared and analyzed at T 0(when the patients enrolled the study)and T1(when the patients diagnosed SIMD).Re-sults The morbidity of SIMD in esmolol group were decreased compared with those in control group(42.5%vs.58%,χ2=5.145,P<0.05).In T1phase,the levels of NT-proBNP(t=2.567,P=0.008)and LVEDD(t=1.782,P=0.042)in control group were increased in comparison of control group,while LVEF(t=2.052,P=0.024)and DC(t=2.419,P=0.011)were decreased.Only NT-proBNP was elevated in esmolol group in T 1phase(t=2.107,P=0.022).The levels of NT-proBNP in esmolol group were lower than those in control group(t=2.455,P=0.010),while levels of LVEF were higher than those in control group(t=2.607,P=0.007).Correlation analysis showed that DC(r=0.637,P<0.05)and esmolol (r=0.685,P<0.05)was negatively associated with the morbidity of SIMD.DC was negatively related with esmolol(r=0.699,P<0.05).Logistic regression analysis showed that esmolol could reduce the morbidity of SIMD by 22%,while every 1 ms of DC could increase the morbidity by 27%.Conclusion Early phase esmolol intervention may improve the fluctuation of DC and reduce the morbidity of SIMD in sepsis patients.关键词
脓毒症/脓毒症导致心功能障碍/心率减速力/艾司洛尔Key words
Sepsis/Sepsis induced myocardial dysfunction/Deceleration capacity,Esmolol
