去甲肾上腺素与多巴胺对感染性休克患者血乳酸水平生命体征及预后的影响

Influence of NE and DA on blood lactate level,vital signs and prognosis in patients with severe septic shock

目的探讨去甲肾上腺素(NE)与多巴胺(DA)对感染性休克患者的血乳酸水平、生命体征及预后的影响。方法选取2011年5月至2015年5月收治的90例重症感染性休克患者,采用随机区组法分为A组(45例)和B组(45例),分别采用DA和NE微量泵入;比较两组患者治疗前后心率(HR)、平均动脉压(MAP)、血乳酸水平,血乳酸清除率和住院病死率等。结果两组患者治疗后HR水平均低于治疗前(P<0.05);B组患者治疗后血乳酸水平,12 h和24 h血乳酸清除率明显高于A组(P<0.05);B组患者住院病死率明显低于A组(P<0.05)。结论与DA治疗效果相比,NE微量泵入治疗感染性休克,具有稳定生命体征,改善血乳酸清除效果和降低病死率的优点。

Objective To investigate the influence of Norepinephrine( NE) and Dopamine( DA) on bloodlactate level,vital signs and prognosis in patients with severe septic shock. Methods 90 patients with severe septic shock ever treated in our hospital from May 2011 to May 2015 were chosen and divided,with randomized block method,into two groups: group A( 45 cases) wasinfusedwith dopamine by micro pump and group B( 45 cases) infusedwith norepinephrine by micro pump. The levels of heart rate( HR),mean arterial pressure( MAP) and blood lactate before and after treatment,the blood lactate clearance rate and the clinical mortality in hospital of patients in both groups were compared. Results The HR levelsof patients in both groups after treatment were significantly lower than those in both groups before treatment( P < 0. 05). The blood lactatelevels and blood lactate clearance rateof group B at 12 h and 24 h after treatment were significantly higher than those of group A( P < 0. 05). The clinical mortality in hospital of group B was significantly lower than that of group A( P < 0. 05). Conclusion Compared with efficacy of DAinfusion by micro pump,NE infusionin treatment of patients with severe septic shock hasadvantages instabilizing vital signs,improving blood lactate clearance effect and reducing mortality in hospital.