摘要
目的：比较去甲肾上腺素（NE）与多巴胺（DE）治疗感染性休克（SS）的临床效果和安全性。方法：66例SS患者随机均分为NE组和DE组。DE组患者给予DE初始剂量每分钟1μg/kg,中央静脉持续泵入48 h,后每隔2 min增加1μg,至动脉压（MAP）70～80 mm Hg;NE组患者给予NE初始剂量每分钟0.05μg/kg,中央静脉持续泵入48 h,后每隔2 min增加0.05μg,至MAP 70～80mm Hg;与此同时,两组患者均给予给予抗菌药物、吸氧、营养支持等治疗并进行心电监测指标。观察两组患者治疗前及治疗后4、8、12、24、48 h血流动力学指标[心率（HR）、心排出量指数（COI）、MAP、外周血管阻力指数（SVRI）],组织氧代谢指标[乳酸清除率（LCR）、混合静脉血氧饱和度（Sv O2）],病死率及不良反应发生情况。结果：治疗后,NE组患者各时间点HR、COI均显著低于同组治疗前及DE组,SVRI显著高于同组治疗前及DE组,差异均有统计学意义（P〈0.05）;但两组患者各时间点MAP比较,差异无统计学意义（P〉0.05）。两组患者各时间点LCR和SVO2（除治疗后4 h外）均显著高于同组治疗前,且NE组高于DE组,差异均有统计学意义（P〈0.05）。两组患者病死率比较,差异无统计学意义（P〉0.05）。NE组患者不良反发生率显著低于DE组,差异均有统计学意义（P〈0.05）。结论：NE治疗SS较DE可有效改善患者血流动力学指标和组织氧代谢指标水平,安全性较好。
OBJECTIVE： To compare the clinical efficacy and safety of norepinephrine （NE） and dopamine （DE） in the treat- ment of septic shock （SS）. METHODS：66 SS patients was retrospectively analyzed and randomly divided into NE group and DE group. DE group was treated with DE with the initial dose and then increased 1 /.tg every 2 min to maintain the arterial of 1 pg/kg per minute by continuous infusion in central venous 48 h, pressure（MAP） 70-80 mm Hg per minute; NE group was treated with NE the initial dose of 0.05 p.g/kg per minute b5 continuous infusion in central venous 48 h, and then increased 0.05 pg/time every 2 min to maintain the MAP 70-80 mm Hg per minute. At the same time,all patients were given antibiotics, oxygen inhalation, nu- tritional support and other treatment and were given ECG monitoring. The clinic data was observed, including the hemodynamic in- dexes [heart rate （HR）, cardiac output index （COI）,MAP and systemic vascular resistance index （SVRI）], the tissue oxygenation indexes [lactate clearance rate （LCR） and central venous oxygen saturation （SvO2）] before and 4,8,24 and 48 h after treatment, the morality rate and incidence of adverse reactions. RESULTS： After treatment, HR and COI in NE group were significantly lower than before and DE group in different time points, SVRI was significantly higher than before and DE group, the differences were statistically significant（P〈0.05）. But there was no significant difference in the MAP between 2 groups in different time points（P〉 0.05）. LCR and SVO2（except for after 4 h treatment）in 2 groups was significantly higher than before in different time points, and NE group was higher than DE group; the difference was statistically significant（P〈0.05）. There was no significant difference in the morality rate between 2 groups（P〉0.05）. Incidence of adverse reactions in NE group was significantly lower than DE group, the differences were statistically significant（P〈0.05）. CONCLUSIONS：Compar
出处
《中国药房》
CAS
北大核心
2015年第27期3794-3796,共3页
China Pharmacy
