目的 探討鹽酸艾司洛爾注射液對(duì)膿毒性休克患者心功能的改善作用。方法 選取2015年2月—2016年12月項(xiàng)城市第一人民醫(yī)院收治的膿毒性休克患者70例，按隨機(jī)數(shù)字表法將患者分為對(duì)照組和治療組，每組各35例。對(duì)照組給予常規(guī)干預(yù)治療，包括補(bǔ)液、營(yíng)養(yǎng)支持、抗感染、糾正水、電解質(zhì)酸堿平衡、呼吸循環(huán)支持等。治療組在對(duì)照組基礎(chǔ)液體復(fù)蘇24 h后靜脈滴注鹽酸艾司洛爾注射液，初始劑量為50 mg/h，根據(jù)患者的血壓、心率情況調(diào)整使用劑量，治療24 h。觀察兩組的臨床療效，比較兩組的血液灌注指標(biāo)、血流動(dòng)力學(xué)指標(biāo)、心肌標(biāo)志物和心肌組織代謝指標(biāo)的情況。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為71.48%、91.43%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P< 0.05）。治療后，兩組平均動(dòng)脈壓（MAP）和心率（HR）均降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P< 0.05）；且治療組HR的下降程度明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P< 0.05）。治療后，兩組心排血指數(shù)（CI）均降低，而外周血管阻力指數(shù)（SVRI）和全心舒張期末容積指數(shù)（GEDVI）均升高，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P< 0.05）；且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P< 0.05）。治療后，兩組乳酸（Lac）水平均顯著降低，而肌鈣蛋白I（cTnI）水平均顯著升高，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P< 0.05）；且治療組cTnI水平明顯高于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P< 0.05）。結(jié)論 鹽酸艾司洛爾注射液可顯著改善膿毒性休克心功能，調(diào)節(jié)血液灌注指標(biāo)、血流動(dòng)力學(xué)指標(biāo)、心肌標(biāo)志物和組織代謝指標(biāo)，安全性較好，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the effect of Esmolol Hydrochloride Injection in improvement of septic shock cardiac function. Methods Patients (70 cases) with septic shock in The First People's Hospital of Xiangcheng from February 2015 to December 2016 were randomly divided into control and treatment groups, and each group had 35 cases. Patients in the control group were given routine intervention treatment, including fluid replacement, nutritional support, anti-infection, correct water and electrolyte acid-base balance, respiration support, and circulation support. Patients in the treatment group were iv administered with Esmolol Hydrochloride Injection after 24 h of fluid resuscitation on the basis of the control group. The initial dose was 50 mg/h, and the dosage was adjusted according to the patient's blood pressure and heart rate, and were treated for 24 h. After treatment, the clinical efficacies were evaluated, and blood perfusion indexes, hemodynamic indexes, myocardial marker, and myocardial tissue metabolic indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 71.48% and 91.43%, respectively, and there was difference between two groups (P < 0.05). After treatment, MAP and HR in two groups were decreased, and the difference was statistically significant in the same group (P < 0.05). And the HR in the treatment group was significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the CI in two groups was decreased, but SVRI and GEDVI in two groups were increased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the Lac levels in two groups were significantly decreased, but the cTnI levels in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the cTnI level in the treatment group was significantly higher than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Esmolol Hydrochloride Injection can improve septic shock cardiac function, regulate blood perfusion index, hemodynamic index, myocardial marke, and myocardial tissue metabolic index, with good safety, which has a certain clinical application value.