多巴酚丁胺辅助治疗对重症肺炎患儿PCTBNP D-二聚体以及PCIS评分的影响

Effects of dobutamine auxiliary on PCT,BNP,D-dimer and PCIS score in children with severe pneumonia

目的探讨重症肺炎患儿给予多巴酚丁胺辅助治疗对血降钙素原(PCT)、脑钠肽(BNP)、D-二聚体(DD)以及小儿危重症评分(PCIS)的影响。方法从我院2014年10月~2017年10月就诊的重症肺炎患儿中选取86例作为研究对象,随机均分为两组,常规组43例给予常规治疗,研究组43例在常规治疗基础上给予多巴酚丁胺辅助治疗,对比两组患儿治疗疗效,以及治疗前后PCT、BNP、DD以及PCCIS评分情况。结果治疗后研究组BNP、DD、PCT水平显著低于常规组,差异均有统计学意义(t=15.403,t=26.867,t=7.681,均P<0.05);研究组患儿PICS评分(P<0.05)及PaO_2、SpO_2水平均显著高于常规组,差异均有统计学意义(t=5.655,t=3.977,t=4.904,均P<0.05);研究组治疗总有效率(97.7%)亦显著高于常规组(72.1%),差异有统计学意义(χ~2=10.965,P<0.05);两组患儿不良反应发生率差异无统计学意义(χ~2=0.453,P>0.05)。结论重症肺炎患儿给予多巴酚丁胺辅助治疗疗效显著,可有效改善患儿血清细胞因子及PCT水平,且不良反应发生率低,安全可靠。

Objective To investigate the effect of dobutamine assisted treatment on serum procalcitonin(PCT),brain natriuretic peptide(BNP),D-dimer(DD)and PCIS score in children with severe pneumonia.Methods 86 children with severe pneumonia in our hospital from October 2014 to October 2017 were selected and randomly divided into 2 groups.43 cases in the conventional group were given routine treatment,while 43 cases in the study group were given dobutamine assisted treatment on the basis of routine treatment.The curative effect and the scores of PCT,BNP,DD and PCCIS before and after treatment were compared.Results After treatment,the levels of BNP,DD and PCT in the study group were significantly lower than those in the conventional group,and the differences were statistically significant(t=15.403,t=26.867,t=7.681,P<0.05).The PICS scores in the study group were significantly higher than those in the conventional group,and the differences were statistically significant(t=5.655,P<0.05).PaO 2 and SpO 2 were significantly higher in the study group than in the conventional group,the differences were statistically significant(t=3.977,t=4.904,P<0.05);the total effective rate of the study group was 97.7%,which was significantly higher than 72.1%of the conventional group,the difference was statistically significant(2=10.965,P<0.05);There was no significant difference in the incidence of adverse reactions between the two groups(χ2=0.453,P>0.05).Conclusion Dobutamine assisted treatment is an effective and safe way to improve the serum cytokines and PCT levels for severe pneumonia children with lower incidence of adverse reactions.