中国中西医结合急救杂志2026，Vol.33Issue(4)：415-418,4.DOI:10.3969/j.issn.1008-9691.2026.04.005
β受体阻滞剂对脓毒性休克患者肺和肠道保护作用的研究
Study of the protective effects of β receptor blockers on the lungs and intestines in patients with septic shock
摘要
Abstract
Objective To observe the effect of β receptor blockers(Esmolol)on pulmonary oxygenation and intestinal barrier function in patients with septic shock.Methods A total of 63 patients with septic shock admitted to the department of intensive care unit(ICU)of Nanjing Jiangbei Hospital Affiliated to Nantong University from January 2023 to March 2025 were enrolled.Four patients failed to complete the trial,including 2 intolerant to the minimum dose of Esmolol and 2 who withdrew treatment during the study.Finally,a total of 59 patients were included.Patients were divided into a control group(29 cases)and an Esmolol group(30 cases)using the random number table method.All patients received standardized treatment,including infection control,fluid resuscitation,anti-shock therapy,mechanical ventilation,analgesia and sedation.Patients in the Esmolol group received continuous intravenous infusion of Esmolol at an initial dose of 25 mg/h.The dose was titrated by 50 mg/h every 20 minutes to achieve the target heart rate of 80-94 beats/min and maintained for 72 hours.Mean arterial pressure(MAP),heart rate and oxygenation index(PaO2/FiO2)at baseline,48 hours and 72 hours after enrollment.Intestinal barrier markers including diamine oxidase(DAO)and D-lactate at baseline and 72 hours after enrollment,and 28-day mortality were compared between the two groups.Results There were no significant intergroup differences in baseline PaO2/FiO2,DAO,D-lactate,heart rate,MAP,and MAP at 48 hours and 72 hours(all P>0.05).The PaO2/FiO2 at 48 hours was significantly higher in the Esmolol group than that in the control group[mmHg(1 mmHg≈0.133 kPa):302.6±62.6 vs.272.8±45.5,P<0.05].Although PaO2/FiO2 at 72 hours remained higher in the Esmolol group,the difference was not statistically significant(P>0.05).The 72 hours levels of DAO and D-lactate,as well as heart rate at 48 hours and 72 hours in the Esmolol group were all significantly lower than those in the control group[72 hours DAO(U/L):8.9(6.9,11.5)vs.11.6(9.1,15.1);72 hours D-lactate(mg/L):10.2(8.2,12.1)vs.12.9(9.4,15.8);48 hours heart rate(bpm):86.2±4.4 vs.96.6±10.7;72 hours heart rate(bpm):82.9±6.9 vs.92.8±11.7,all P<0.05].The 28-day mortality rate in the Esmolol group was lower than in the control group,but the difference was not statistically significant(P>0.05).Conclusions Esmolol improves early pulmonary oxygenation in patients with septic shock,whereas this beneficial effect diminishes over time.Esmolol protects intestinal barrier function but does not reduce the 28-day mortality.关键词
脓毒性休克/艾司洛尔/氧合指数/肠道屏障功能Key words
Septic shock/Esmolol/Oxygenation index/Intestinal barrier function引用本文复制引用
刘尚香,叶正龙,邹晖,梅程清,胡志青,徐维慧,吴勇..β受体阻滞剂对脓毒性休克患者肺和肠道保护作用的研究[J].中国中西医结合急救杂志,2026,33(4):415-418,4.基金项目
安徽省危重症呼吸疾病临床医学研究中心校级开放课题(LC202210) Anhui Provincial Clinical Medical Research Center for Critical Respiratory Diseases Open Project of the University(LC202210) （LC202210）
