美托洛尔联合多巴胺对重症肺炎伴心力衰竭患儿的临床疗效研究

Clinical Efficacy of Metoprolol Combined with Dopamine in Children with Severe Pneumonia Complicated with Heart Failure

目的:探讨美托洛尔联合多巴胺对重症肺炎伴心力衰竭患儿的临床疗效。方法:选择2015年6月至2016年12月重症肺炎伴心力衰竭患儿140例,采取分层随机分组法将患儿分为观察组和对照组,每组70例。入院即对患儿行基础支持治疗和抗感染治疗,纠正低血容量后给予两组患者等量多巴胺静脉滴注,观察组在此基础上给予口服美托洛尔联合治疗,疗程均为7d。比较两组患者治疗后的临床总有效率,治疗前后心率、呼吸频率、血氧饱和度、血清CK-MB、LDH水平的变化,临床症状和体征改善时间以及治疗前后的变化。结果:治疗后,观察组的治疗总有效率(92.86%)显著高于对照组(74.29%,P=0.00);两组患者治疗后心率、呼吸频率、血清CK-MB、LDH水平均较治疗前显著降低,且观察组显著低于对照组(P<0.05);两组患者治疗后血氧饱和度均较治疗前显著升高,且观察组血氧饱和度显著高于对照组(P<0.05);观察组患者临床症状和体征改善时间显著短于对照组(P<0.05)。结论:美托洛尔联合多巴胺治疗重症肺炎伴心力衰竭患儿的临床疗效显著,能有效改善患者症状体征,缩短临床症状和体征改善时间。

Objective： To investigate the clinical efficacy of metoprolol combined with dopamine in the treatment of severe pneumonia complicated with heart failure. Methods： 140 cases of children with severe pneumonia combined with heart failure were selected from June 2015 to December 2016 and randomly divided into the control group and the observation group,70 cases in each group. Basic supportive therapy and antiinfection treatment,correction of hypovolemia were given to both groups of patients,then equal amount of dopamine was given to both groups via intravenous drip,the observation group was given oral metoprolol treatment on the basis of control group,all the treatment lasted for 7 days. The total effective rate,changes of heart rate,breathing rate and blood oxygen saturation,CK-MB,LDH levels before and after the treatment,improvement time of clinical symptoms and signs were compared between two groups of patients. Results： After treatment,the total efficiency of observation group（ 92.86%） was significantly higher than that of the control group（ 74.29%）（ P = 0. 00）; the heart rate,respiratory rate,serum CK-MB,LDH levels after treatment were significantly lower than those before treatment,which were significantly lower in the observation group than those of the control group（ P〈0.05）; the blood oxygen saturation of both groups after treatment were significantly higher than those before treatment,which was significantly higher in the observation group than that of the control group（ P〈0.05）; the improvement time of symptoms and signs in observation group were shorter than those of the control group（ P〈0.05）. Conclusion： Metoprolol combined with dopamine could effectively improve the symptoms and signs,shorten the time of clinical symptoms and signs in the treatment of severe pneumonia with heart failure in children.