多巴酚丁胺注射液联合亚胺培南对先心病并肺炎心衰患者IGF-1和IGFBP-3水平的影响

Effects of dobutamine injection combined with imipenem on IGF-1 and IGFBP-3 levels in heart failure of patients with congenital heart disease and pneumonia

目的探讨多巴酚丁胺注射液联合亚胺培南对先心病并肺炎心衰患者血清类胰岛素增长因子1(insulin-like growth factor 1,IGF-1)和胰岛素样生长因子结合蛋白-3(insulin-like growth factor binding protein-3,IGFBP-3)水平的影响。方法选取62例先心病并肺炎心衰患儿,随机分成2组,每组31例。对照组在常规治疗基础上予多巴酚丁胺注射液治疗,联合组在上述治疗上再予亚胺培南治疗,检测治疗前后血清IGF-1及IGFBP-3水平,血流动力学以及血浆脑钠肽(brain natriuretic peptide,BNP)水平,记录临床症状缓解时间,观察临床疗效及安全性。结果与治疗前比较,2组血清IGF-1及IGFBP-3水平升高(P<0.01),左室射血分数(left ventricular ejection fraction,LVEF)升高(P<0.05),血浆BNP水平降低(P<0.05);与对照组比较,联合组血清IGF-1及IGFBP-3水平较高(P<0.01),LVEF较高(P<0.05),血浆BNP水平较低(P<0.05),呼吸困难消失时间、心率正常时间、肝脏回缩时间以及肺部罗音消失时间均较短(P<0.05),治疗有效率较高(P<0.05)。结论多巴酚丁胺注射液联合亚胺培南治疗先心病并肺炎心衰有较好疗效,改善血流动力学效应,缓解心衰症状,且升高血清IGF-1及IGFBP-3水平。

Objective To investigate the effects of dobutamine injection combined with imipenem on serum insulin-like growth factor 1（IGF-1）and insulin-like growth factor binding protein-3（IGFBP-3） levels in heart failure of patients with congenital heart disease and pneumonia. Methods A total of 62 children with heart failure of patients with congenital heart disease and pneumonia were collected and randomly divided into 2 groups with 31 cases in each group. Patients in the control group were treated on the basis of the routine treatment with dobutamine injection,and patients in the experimental group were treated on the basis of the control group with imipenem treatment. The serum IGF-1 and IGFBP-3 levels,plasma BNP level,hemodynamics were detected before and after treatment, the clinical symptoms remission time, clinical efficacy and safety were recorded.Results Compared with before treatment,serum IGF-1 and IGFBP-3 levels of 2 groups increased（P 〈0. 01）,LVEF increased（P 〈0. 05）,the plasma BNP level decreased（P 〈0. 05）; compared with the control group,the serum IGF-1 and IGFBP-3 levels of the experimental group were higher（P 〈0. 01）,LVEF was higher（P 〈0. 05）,the plasma BNP level was lower（P 〈0. 05）,breathing difficulty disappeared time,heart rate in normal time,liver retraction time and pulmonary rales disappearance time were shorter（P 〈0. 05）,and the clinical effective rate was higher（P 〈0. 05）. Conclusion Dobutamine injection combined with imipenem in the treatment of heart failure in patients with congenital heart disease and pneumonia has good clinical efficacy,improve the hemodynamic effect,alleviate symptoms of heart failure,and increase the serum IGF-1 and IGFBP-3 levels.