不同升压药物对感染性休克患者血乳酸及预后影响的比较

Comparision of different vasopressors in blood lactate and prognoss of the patients with septic shock

目的探讨不同升压药物对感染性休克患者血乳酸及预后的影响。方法收集本科室收治的感染性休克患者共80例,随机分为两组,其中一组患者使用多巴胺(DA)治疗(DA组,40例);另一组使用去甲肾上腺素(NA)治疗(NA组,40例),两组患者液体复苏及一般治疗方法无差异。用药8 h后,观察两组患者血流动力学、血乳酸、乳酸清除率及病死率。结果治疗8 h后,两组患者的心率增快及平均动脉压(MAP)升高的程度无统计学差异(P均>0.05)。治疗8 h后NA组的乳酸清除率显著大于DA组(χ2=4.206,P<0.05)。DA组病死率高于NA组,差异具有统计学意义(χ2=5.41,P<0.05)。结论 NA和DA对维持感染性休克患者血流动力学稳定均有效,NA能更有效地清除血乳酸及降低患者的病死率。

Objective To compare the different vasopressors in blood lactate and prognoss of the patients with septic shock. Methods Toal of 80 cases patients with septic shock were collected, and they were randomly divided into two groups. One group were given dopamine （DA group, with 40 cases）, the other group were given norepinephrine （NA group, with 40 cases）. Hemodynamic, blood lactate, lactate clearance rate and mortaity of the two groups after treatment 8 h were compared, respectively.Results The hear rate and mean arterial pressure （MAP） of the two group after treatment 8 h was with no statistical difference in the degree of increase （P〉0.05）. Lactate clearance rate of NA group was higher than DA group after treatment 8 h （χ2= 4.206,P〈 0.05）. Mortaity rate of the DA group was signiifcantly higher than that in NA group （χ2= 5.41,P〈0.05）.Conclusions NA and DA also have effective in hemodynamic stability in the patients with septic shock. NA has more effective in clearing blood lactate and reducing mortality.