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中华重症医学电子杂志 ›› 2017, Vol. 03 ›› Issue (03) : 174 -177. doi: 10.3877/cma.j.issn.2096-1537.2017.03.004

所属专题: 重症医学 文献

专题笔谈

β受体阻断剂在脓毒症和脓毒性休克中的应用
李佳1, 郭旋2, 董士民2,()   
  1. 1. 050051 石家庄市中医院急诊科
    2. 050051 石家庄,河北医科大学第三医院急诊科
  • 收稿日期:2016-06-17 出版日期:2017-08-28
  • 通信作者: 董士民

Application of Beta blockers in severe sepsis and septic shock

jia Li1, Xuan Guo2, Shimin Dong2,()   

  1. 1. Department of emergency, Shijiazhuang Hospital of Traditional Chinese Medicine, Shijiazhuang 050051, China
    2. Department of emergency, The Third hospital of Hebei Medical University, Shijiazhuang 050051, China
  • Received:2016-06-17 Published:2017-08-28
  • Corresponding author: Shimin Dong
  • About author:
    Corresponding author: Dong Shimin, Email:
引用本文:

李佳, 郭旋, 董士民. β受体阻断剂在脓毒症和脓毒性休克中的应用[J]. 中华重症医学电子杂志, 2017, 03(03): 174-177.

jia Li, Xuan Guo, Shimin Dong. Application of Beta blockers in severe sepsis and septic shock[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2017, 03(03): 174-177.

脓毒症病情发展快,极易发生感染性休克及多脏器衰竭,预后差,病死率高。其中脓毒血症引起的心脏损害是其严重并发症,也是导致患者死亡的主要原因。因β受体阻断剂在慢性心力衰竭、冠状动脉原因导致的心肌损害的治疗中发挥着重要作用,因此国内外部分学者将其尝试应用于治疗脓毒症及脓毒性休克。本文将其研究结果整理,综述如下。

Sepsis, which can easily develop to septic shock and multiple organ failure, induce a poor prognosis and high mortality. The myocardial injury caused by sepsis is a serious complication and a leading cause of death in sepsispatients. Beta blockers play an important role in the treatment of chronic heart failure and cardiac ischemia. Therefore, some scholars tried to apply it in the treatment of sepsis and septic shock. In this review, the results of these studies are summarized.

1
American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis[J]. Crit Care Med, 1992, 20(6): 864-874.
2
Zanotti-Cavazzoni SL, Hollenberg SM. Cardiac dysfunction in severe sepsis and septic shock[J]. Curr Opin Crit Care, 2009, 15(5): 392-397.
3
Parker MM. Sepsis-Induced Myocardial Dysfunction: Another Piece in the Puzzle[J]. Pediatr Crit Care Med, 2016, 17(5): 457-458.
4
Zang QS, Wolf SE, Minei JP. Sepsis-induced Cardiac Mitochondrial Damage and Potential Therapeutic Interventions in the Elderly[J]. Aging Dis, 2014, 5(2): 137-149.
5
Horton JW, Maass DL, Ballard-Croft C. Rho-associated kinase modulates myocardial inflammatory cytokine responses[J]. Shock, 2005, 24(1):53-58.
6
刘勇, 林建东, 肖雄箭, 等. 脓毒症大鼠心脏组织基因表达变化的研究[J].中国危重病急救学, 2009, 2(3): 155-159.
7
Shao Y, Redfors B, Scharin Täng M, et al. Novel rat model reveals important roles of β-adrenoreceptors in stress-induced cardiomyopathy[J]. Int J Cardiol, 2013, 168(3): 1943-1950.
8
Court O, Kumar A, Parrillo JE, et al. Clinical review: Myocardial depression in sepsis and septic shock[J]. Crit Care, 2002, 6(6): 500-508.
9
Merx MW, Weber C. Sepsis and the heart[J]. Circulation, 2007, 116(7): 793-802.
10
秦延军, 于悦卿, 闫雁, 等. 艾司洛尔对早期脓毒症大鼠炎症因子及心功能的影响[J]. 中国现代医学杂志, 2014, 24(1): 13-19.
11
Piquereau J, Godin R, Deschênes S, et al. Protective role of PARK2/Parkin in sepsis-induced cardiac contractile and mitochondrial dysfunction[J]. Autophagy, 2013, 9(11): 1837-1851.
12
Stengl M, Bartak F, Sykora R, et al. Reduced L-type calcium current in ventricular myocytes from pigs with hyperdynamic septic shock[J]. Crit Care Med, 2010, 38(2): 579-587.
13
Cohen RI, Wilson D, Liu SF. Nitric oxide modifies the sarcoplasmic reticular calcium release channel in endotoxemia by both guanosine-3′, 5′ (cyclic) phosphate-dependent and independent pathways[J]. Crit Care Med, 2006, 34(1): 173-181.
14
Flynn A, Chokkalingam Mani B, Mather PJ. Sepsis-induced cardiomyopathy: a review of pathophysiologic mechanisms[J]. Heart Fail Rev, 2010, 15(6): 605-611.
15
Potz BA, Sellke FW, Abid MR. Endothelial ROS and Impaired Myocardial Oxygen Consumption in Sepsis-induced Cardiac Dysfunction[J]. J Intensive Crit Care, 2016, 2(1). pii: 20.
16
Romero-Bermejo FJ, Ruiz-Bailen M, Gil-Cebrian J, et al. Sepsis-induced cardiomyopathy[J]. Curr Cardiol Rev, 2011, 7(3): 163-183.
17
Chacko CJ, Gopal S. Systematic review of use of β-blockers in sepsis[J]. J Anaesthesiol Clin Pharmacol, 2015, 31(4): 460-465.
18
Morelli A, Ertmer C, Westphal M, et al. Effect of heart rate control with esmolol on hemodynamic and clinical outcomes in patients with septic shock: a randomized clinical trial[J]. JAMA, 2013, 310(16): 1683-1691.
19
Schmittinger CA, Dünser MW, Haller M, et al. Combined milrinone and enteral metoprolol therapy in patients with septic myocardial depression[J]. Crit Care, 2008, 12(4): R99.
20
Contenti J, Occelli C, Corraze H, et al. Long-Term β-Blocker Therapy Decreases Blood Lactate Concentration in Severely Septic Patients[J]. Crit Care Med, 2015, 43(12): 2616-2622.
21
Maláska J, Slezák M, Muriová K, et al. Myocardial dysfunction in sepsis--diagnostics and therapy[J]. Vnitr Lek, 2010, 56(3): 226-232.
22
Lorigados CB, Soriano FG, Szabo C. Pathomechanisms of myocardial dysfunction in sepsis[J]. Endocr Metab Immune Disord Drug Targets, 2010, 10(3): 274-284.
23
Ibrahim-Zada I, Rhee P, Gomez CT, et al. Inhibition of sepsis-induced inflammatory response by β1-adrenergic antagonists[J]. J Trauma Acute Care Surg, 2014, 76(2): 320-327
24
Kimmoun A, Louis H, Al Kattani N, et al. β1-Adrenergic Inhibition Improves Cardiac and Vascular Function in Experimental Septic Shock[J]. Crit Care Med, 2015, 43(9): e332-e340.
25
Thum T, Fraccarollo D, Schultheiss M, et al. Endothelial nitric oxide synthase uncoupling impairs endothelial progenitor cell mobilization and function in diabetes[J]. Diabetes, 2007, 56(3): 666-674.
26
胡英, 徐蓉, 杨珍珍, 等. 美托洛尔在抗心律失常治疗中的应用优势[J]. 中华临床医师杂志(电子版), 2013, 7 (11): 4950-4952.
27
Cheng J, Niwa R, Kamiya K, et al. Carvedilol blocks the repolarizing K+ currents and the L-type Ca2+ current in rabbit ventricular myocytes[J]. Eur J Pharmacol, 1999, 376(1-2): 189-201.
28
冯耀光, 朱德胜, 王元星, 等. 血管紧张素转换酶抑制剂与β-受体阻滞剂对心瓣膜置换术后心脏结构及功能的影响[J]. 中国胸心血管外科临床杂志, 2011, 18(4): 377-379.
29
Pemberton P, Veenith T, Snelson C, et al. Is It Time to Beta Block the Septic Patient? [J]. Biomed Res Int, 2015, 2015: 424308.
30
Morelli A, Ertmer C, Westphal M, et al. Effect of heart rate control with esmolol on hemodynamic and clinical outcomes in patients with septic shock: a randomized clinical trial[J]. JAMA, 2013, 310(16): 1683-1691.
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