关键词: 休克, 脓毒性, 液体复苏, 左心室舒张功能, 心肌损伤

Abstract: ［Abstract］ Objective〖HTSS〗〓To observe and to explore effects of early fluid resuscitation on left ventricular diastolic function in patients with septic shock.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Fortyfive septic shock patients with left ventricular diastolic dysfunction were chosen. Patients who achieved the resuscitation goals(central venous pressure 8-12 mmHg, or 12-15 mmHg during mechanical ventilation, mean arterial pressure≥65 mmHg, urine volume≥0.5 mL·kg-1·h-1, central venous oxygen saturation≥70% after 6 hours treatment of early fluid resuscitation) were assigned into observation group(31cases). Patients who did not achieve the resuscitation goals were assigned into control group(14 cases). As the evaluation index of left ventricular diastolic function, the ratio of early diastolic mitral inflow velocity to early diastolic mitral annulus velocity(E/e′) was observed by bedside ultrasound. Meanwhile, the myocardial injury markers including cardiac troponin I(cTnI) and Nterminal probrain natriuretic peptide(NTproBNP) were observed.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The duration of mechanical ventilation and length of stay in intensive care unit were significantly shorter in observation group compared with control group, meanwhile the incidence of multiple organ dysfunction syndrome and 28 daymortality were decreased significantly(P＜0.05). E/e′ and NTproBNP in observation group were decreased remarkably after fluid resuscitation(P＜0.05). E/e′, cTnI and NTproBNP were significantly lower in observation group compared with control group(P＜005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Left ventricular diastolic dysfunction could be improved evidently through early fluid resuscitation. Effect of myocardial injury was relieved and prognosis was improved in patients with septic shock.

Key words: shock, septic, fluid resuscitation, left ventricular diastolic function, myocardial injury