Abstract:【Objective】To investigate the relationship between high and low blood pressure (BP) targets and mortality in elderly patients with septic shock at 28 days and 90 days.【Methods】A total of 80 elderly patients with septic shock were randomly divided into the high target BP group (A) and low target BP group (B), with 40 cases in each group. All patients were treated with cluster therapy of septic shock. The MAP of A group and B group were controlled in 80~85mmHg and 65~70 mmHg, respectively. The survival status and related factors of the two groups at 28d and 90d were statistically analyzed.【Results】There was no significant difference in the relevant indicators between the two groups on admission (P>0.05). At 5 days after admission, the levels of MAP, SVRI, ScvO2of A group patients were significantly higher than those of B group patients. However, the level of ELWI, MODS and SOFA score were significantly lower in A group patients than in B group patients (P<0.05). The mortality rates in the A group at 28d and 90d were 32.50% and 45.00% respectively; they were not significantly different from those in the B group (42.50% and 60.00%, respectively, P>0.05). Univariate analysis showed that age, 5-day MAP, SVRI, ELWI, ScvO2, MODS, and SOFA scores after admission were independent risk factors affecting patients 28-day survival (P<0.05). It also showed that age, 5-day MAP, ScvO2, MODS, and SOFA scores after admission were independent risk factors that affected the 90-day survival of patients (P<0.05).【Conclusion】Setting high blood pressure targets is a promising idea in cluster therapy to improve hemodynamics, tissue perfusion and oxygen metabolism in elderly patients with septic shock. It can reduce the MODS and SOFA scores which may in turn lead to decreased mortality rates.
吕立文,唐宇涛,潘春熹,李喆,卢一郡. 高/低目标血压与老年脓毒症休克患者28d和90d病死率的关系[J]. 医学临床研究, 2018, 35(4): 632-634.
LU Li-wen, TANG Yu-tao, PAN Chun-xi, et al. Relationship between High and Low Blood Pressure Targets and Mortality in Elderly Patients with Septic Shock at 28d and 90d. JOURNAL OF CLINICAL RESEARCH, 2018, 35(4): 632-634.
[1] 刘旭,吕隽,李文强,等.急诊脓毒症病死率评分在急诊脓毒症休克患者中的应用研究[J].医学临床研究,2016,33(2):216. [2] 任珊,赵鹤龄.拯救脓毒症运动:2012严重脓毒症和脓毒症休克管理指南要点[J].河北医药,2013,35(8):1233-1236. [3] Marshall JC,Cook DJ,Christou NV.et al.Multiple organ dysfunction SCOI'e:a reliable descriptor of a complex clinical outcome[J].Crit Care Med,1995,23(10):1638-1652. [4] Vincent JL,Momno R,Takala J,et al.the SOFA score to describe organ dysfunction/failure.On behalf of the Working Group on Sepsis.Related Problems of the European Society of Intensive Care Medicine[J].Intensive Care Med,1996,22(7):707-710. [5] 赵丽娜,闫海冰,牛科超,等.乌司他丁联合连续血液净化对严重脓毒症患者心肌损伤的保护作用[J].医学临床研究,2016,33(4):644-646. [6] 徐晓军,张晓慧.老年脓毒症性休克患者有创与无创血压监测比较分析[J].解放军预防医学杂志,2016,34(4):625. [7] 张志荣,李强.脓毒症患者血压变异率与病情危重程度的关系研究[J].中国现代医生,2015,53(14):4-6+10. [8] 张春花,邓卓军,郭旋,等.老年脓毒症性休克患者在应用血管活性药物时不同部位有创血压监测的比较分析[J].中国医科大学学报,2017,46(2):1-3.