小剂量多巴胺联合多巴酚丁胺辅助治疗小儿重症肺炎的临床效果及对炎性因子的影响

Clinical effect and safety of small dose dopamine combine dobutamine auxiliary for treatment of children with severe pneumonia

目的探讨小剂量多巴胺联合多巴酚丁胺辅助治疗小儿重症肺炎的临床效果及安全性。方法选择2013年5月—2014年7月诊治的小儿重症肺炎224.例,采用随机数字表法分为对照组和观察组,每组112例。对照组患者采用抗感染、吸氧等常规治疗方法,观察组患者在对照组治疗基础上给予小剂量多巴胺(3.0~5.0^(-1)·kg^(-1)·min^(-1))联合多巴酚丁胺(1.5~2.5μg·kg^(-1)·min^(-1))治疗,比较2组患者的治疗效果、治疗前后血清细胞因子的水平变化情况以及不良反应等。结果观察组总有效率为96.43%,高于对照组的79.46%(x^2=15.20,P<0.05)。观察组患者的发热、心率、呼吸、肺部啰音症状及体征改善所用时间均少于对照组,差异具有统计学意义(P<0.05)。与治疗前比较,2组患者的IL-6、IL-8、CRP以及TNF-α水平均有明显下降(P<0.05),且观察组较对照组下降明显(P均<0.05)。2组患者的不良反应发生率比较差异无统计学意义(11.61%vs.9.82%,x^2=0.19,P>0.05)。结论小剂量多巴胺联合多巴酚丁胺辅助治疗小儿重症肺炎患者,治疗效果较好,临床症状改善明显,且不良反应发生率较低,值得临床推广应用。

Objective To investigate the clinical effect and safety of small dose dopamine combined with dobutamine in the treatment of children with severe pneumonia.Methods From May 2013 to July 2014, 224 children with severe pneu-monia were enrolled, they were randomly divided into control group and observation group, each group of 112 cases.The con-trol group were treated with anti-infection, oxygen and other conventional treatment, patients in the observation group also re-ceived small dose dopamine （3.0-5.0 μg· kg-1 · min-1 ） combined with dobutamine （1.5 -2.5 μg· kg-1 · min-1 ） treatment, treatment effects were compared between the two groups, before and after treatment, serum cytokine level changes and adverse reaction was observed.Results Observation group’s total efficiency was 96.43%,higher than the control group of 79.46%（χ2 =15.20, P 〈0.05）.Observation groups’ symptoms and signs of fever, heart rate, breath, pulmonary rales’ improvement time was shorter than that of the control group, the difference were statistically significant （ P 〈0.05）.Com-pared with before treatment, 2 groups of patients’ IL-6, IL-8, CRP and TNF-αlevels were decreased significantly （ P 〈0.05）, and the observation group decreased more significantly than the control group （ P 〈0.05）.The incidence of adverse reactions in the 2 groups did not show statistically significant differences （11.61%vs.9.82%,χ2 =0.19, P 〉0.05）.Con-clusion Small dose dopamine combined with dobutamine in adjuvant treatment of infantile severe pneumonia revealed good cur-ative effect, clinical symptoms improved remarkable, adverse reactions occurred rate were low, which is worthy of clinical appli-cation.