摘要
目的:探讨严格液体管理对重症肺炎心脏的保护作用及其可能机制。方法:157例重症肺炎患者随机分为液体管理组和对照组,行脉搏指示连续心输出量监测,评估心输出量(CO)、心指数(CI)、胸腔内血管容量、血管外肺水(EVLWI)的变化,试验前后测定血浆脑型利钠肽(BNP),测定纤支镜肺灌洗液中白细胞介素-6(IL-6)浓度,评估肺组织局部炎症,测定动脉血气评估氧合情况。结果:与对照组相比,液体管理组血浆BNP[(3 283.98±73.91)pg/ml∶(1 584.26±64.71)pg/ml,P<0.05],血流动力学CO[(3.47±0.14)L/(min.m2)∶(4.59±0.37)L/(min.m2),P<0.05]、CI[(3.45±0.24)∶(4.68±0.75),P<0.05]、EVLWI[(7.89±0.74)ml/kg∶(5.67±0.21)ml/kg,P<0.05]均差异有统计学意义,心功能好转,肺组织局部IL-6浓度[(197.51±11.24)pg/ml∶(146.84±10.22)pg/ml,P<0.05]明显下降,动脉血气氧分压[(85.32±14.35)mmHg(1mmHg=0.133kPa)∶(101.43±5.87)mmHg,P<0.05]提高,肺泡-动脉氧分压差[(15.38±3.61)mmHg∶(7.53±3.54)mmHg,P<0.05]下降,肺功能改善。结论:积极液体管理可保护心功能,原因与其改善肺功能、降低炎症反应及改善氧合有关。
Objective：To explore the cardiac protective effects and possible mechanisms in patients with severe pneumonia by liquid management. Method：The 157 cases with severe pneumonia were randomly divided into liquid management group and control group. Pulse indicator continuous cardiac output, cardiac output （CO）, cardiac index （CI）, intrathoracic blood volume index, and the extravascular lung water （EVI.WI） were monitored and guided for the fluid management. The plasma brain natriur,：tic peptide （BNP） was delerminated to assess cardiachmction by fluid management before and after the research. And the interleukin 6 （H76） concentration of bronch- oscopy lung lavage fluid assessed the inflammation in lung tissue, the arterial blood gas anaysis assessed the oxygenation. Result： Compared with the control group, the cardiac function in fluid management group was improved, such as tile concentration of plasma BNP
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2012年第10期768-770,共3页
Journal of Clinical Cardiology
关键词
重症肺炎
液体管理
心功能
severe pneumonia
fluid management
cardiac function
