作者对50例普通内科病房遇到的脓毒性休克(均经血培养证实)治疗前、后的血液动力学进行了研究。本组研究证明,脓毒病早期血液动力变化是血管阻力下降,心输出量增加。如后者不足以代偿前者,则血压下降并发生脓毒性休克。动物实验及人类暂时性菌血症时均证实,休克早期心输出量的增加之所以不能相称地代偿早期血管阻力下降,可能是由于外周血液积聚以及静脉回流的减少。后者可导致心输出量下降。有人认为,心输出量下降亦与休克时存在的心肌抑制因子有关,或与持续性血压下降以及动脉粥样硬化患者冠状动脉灌注减少所造成的心肌功能损伤有关。经血浆容量扩大治疗的部分患者,尽管左室灌注压显著升高,但心输出量及心搏量无明显增加,提示心肌已因脓毒性休克而受到损害。对于脓毒性休克病者如能早期应用血浆容量扩大治疗,可获良好效果, The authors studied the hemodynamics of septic shock (confirmed by blood cultures) in 50 general wards before and after treatment. This group of studies have shown that early hemodynamic changes in sepsis is a decline in vascular resistance, cardiac output increased. If the latter is not enough to compensate for the former, the blood pressure drops and septic shock occurs. Both animal experiments and human transient bacteremia have demonstrated that the increase in early cardiac output during shock does not commensurately compensate for the decline in early vascular resistance, possibly due to a decrease in peripheral blood accumulation and venous return. The latter can lead to decreased cardiac output. It has been suggested that decreased cardiac output is also associated with the presence of myocardial inhibitors of shock or with impaired myocardial blood pressure due to decreased persistent blood pressure and decreased coronary perfusion in atherosclerotic patients. Some patients treated by the expansion of plasma volume, despite a significant increase in left ventricular perfusion pressure, but no significant increase in cardiac output and stroke volume, suggesting that myocardial damage has been due to septic shock. For patients with septic shock if the early application of plasma volume expansion of treatment, can be good results,