左西孟旦对严重脓毒症及脓毒症休克心肌抑制患者心功能的影响

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1、授予单位代码1U089学号或申请号13888國HebeiMedicalUniversity硕士学位论文在职科学学位左西孟旦对严重脓毒症及脓毒症休克心肌抑制患者心功能的影响学位申请人：张力导师：董士民教授专业：急诊医学二级学院：第三医院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师(或指导小组）的指导下，由本人独立完成。本学位论文研究所获得的研究成果,其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公开和使用。凡发表与学位论文主要内容相关的论文,第一署名为单位河北医科大学，试验材料、

2、原始数据、申报的专利等知识产权均归河北医科大学所有。否则，承担相应法律责任。研究生签名：妖力导师签章^二级学院领导盖章：^'5年厂月2分曰河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果，除了文中特别加以标注和致谢等内容外，文中不包含其他人已经发表或撰写的研究成果,指导教师对此进行了审定。本论文由本人独立撰写,文责自负。目录中文摘要·············································································1英文摘要

3、·············································································3研究论文左西孟旦对严重脓毒症及脓毒症休克心肌抑制患者心功能的影响前言············································································6材料与方法····································································7结果···

4、··········································································9附图·············································································11附表·············································································15讨论·····························

5、················································19结论·············································································22参考文献·······································································22综述左西孟旦治疗心力衰竭的临床进展···································26致谢····

6、···············································································33个人简历·············································································34中文摘要左西孟旦对严重脓毒症及脓毒症休克心肌抑制患者心功能的影响摘要目的：随着社会的发展进步，人口的老龄化、外伤的增多，环境污染的加重，还有部分抗生素及激素药物的滥用，使得脓毒症的发病率逐年增加。严重的创伤、

7、休克、感染、外科大手术均可导致脓毒症的发生，部分发展为严重脓毒症、脓毒症休克甚至多器官功能障碍综合症，在当今社会急危重患者的主要死亡原因中比例较大。其中大部分死因为持续性难治性低血压和心血管功能衰竭。左西孟旦是一种新型钙增敏剂，已有许多动物研究发现左西孟旦能改善脓毒症所致的心肌抑制。此研究的目的是为了观察左西孟旦对严重脓毒症及脓毒症休克心肌抑制患者心功能的影响。方法：此项研究在进行前获得了白求恩国际和平医院医学伦理委员会的批准，经患者家属知情同意，从2013年12月至2014年12月，筛选就诊于白求恩国际和平医院重症监护病房内的，

8、入院后被确诊或在检查时根据临床、影像或实验室检查诊断为严重脓毒症及脓毒症休克的患者125例，其中将既往无心脏病病史，经液体复苏后，使用心脏超声评价心功能，左心室射血分数(LVEF)≤45%的27例符合纳入标准，纳入在这项前瞻性观察研究的结果分析中，