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中华重症医学电子杂志 ›› 2021, Vol. 07 ›› Issue (02) : 159 -163. doi: 10.3877/cma.j.issn.2096-1537.2021.02.012

综述

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
高志伟1, 谢剑锋2, 刘玲2, 陈辉2, 李聪2, 杨毅2,()   
  1. 1. 210000 南京,江苏省重症医学重点实验室 东南大学附属中大医院重症医学科;223300 江苏淮安,南京医科大学附属淮安第一医院急诊医学科
    2. 210000 南京,江苏省重症医学重点实验室 东南大学附属中大医院重症医学科
  • 收稿日期:2021-02-07 出版日期:2021-05-28
  • 通信作者: 杨毅
  • 基金资助:
    国家自然科学基金面上项目(81971888); 江苏省社会发展专项(BE2018743); 江苏省医学重点人才项目(ZDRCA2016082); 江苏省淮安市卫生健康科研立项项目(HAWJ201905)

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

Zhiwei Gao1, Jianfeng Xie2, Ling Liu2, Hui Chen2, Cong Li2, Yi Yang2,()   

  1. 1. Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine Southeast University, Nanjing 210000,China; Department of Emergency, the Affiliated Huaian NO.1 People's Hospital of Nanjing Medical University, Huai'an 223300, China
    2. Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine Southeast University, Nanjing 210000,China
  • Received:2021-02-07 Published:2021-05-28
  • Corresponding author: Yi Yang
引用本文:

高志伟, 谢剑锋, 刘玲, 陈辉, 李聪, 杨毅. 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[J/OL]. 中华重症医学电子杂志, 2021, 07(02): 159-163.

Zhiwei Gao, Jianfeng Xie, Ling Liu, Hui Chen, Cong Li, Yi Yang. Clinical research progress of diastolic blood pressure in predicting the progression and guiding the treatment of septic shock[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2021, 07(02): 159-163.

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.

图1 脓毒症导致的低血压或乳酸≥4 mmol/L的初步复苏流程
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