多巴胺联合酚妥拉明治疗小儿肺炎合并心力衰竭的临床研究

Clinical trial of dopamine combined with phentol lemine in the treatment of children pneumonia with heart failure

目的 观察多巴胺联合酚妥拉明治疗小儿肺炎合并心力衰竭的临床效果。方法 将80例肺炎合并心力衰竭患儿随机分为试验组和对照组,各40例。对照组用常规治疗,试验组在对照组的基础上给予多巴胺0. 5 mg·kg-1和酚妥拉明0. 5 mg·kg-1,每天1~3次,静脉滴注。2组连续治疗3 d。比较2组患儿临床症状改善情况,比较治疗前后2组患儿心肌酶谱水平与心脏功能,记录治疗过程中药物不良反应发生情况。结果 治疗后,试验组和对照组乳酸脱氢酶(LDH)分别为(93. 04±4. 55),(124. 73±5. 49) U·L-1,肌酸激酶(CK)分别为(86. 47±18. 46),(113. 94±14. 66) U·L-1,肌酸激酶同工酶(CK-MB)分别为(33. 64±3. 56),(38. 35±6. 53) U·L-1,差异均有统计学意义(均P <0. 05)。治疗后,2组患儿咳嗽、喘息、肺湿啰音消失时间及心力衰竭控制时间差异均有统计学意义(均P <0. 05)。2组患儿左心室舒张末内径(LVEDD)、左心室收缩末内径(LVESD)、左心室每搏量(LVSV)、左心室射血分数(LVEF)差异均无统计学意义(均P> 0. 05)。治疗过程中,对照组患儿发生口腔溃疡1例,腹泻1例,药物不良反应发生率为5. 00%;试验组患儿发生呕吐1例,腹泻3例,药物不良反应发生率为10. 00%。2组药物不良反应差异无统计学意义(P> 0. 05)。结论 多巴胺联合酚妥拉明治疗小儿肺炎合并心力衰竭可更加快速缓解患儿临床症状,改善患儿心肌酶谱水平,且治疗方案安全性良好。

Objective To investigate the clinical effect of dopaminecombined with phentol lemine in the treatment of pneumonia with heart failure in children.Methods Eighty children with pneumonia and heart failure were randomly divided into treatment group and control group,40 cases in each group.Control group was treated with routine therapy,treatment group was treated with dopamine 0.5 mg·kg-1 combined with phentol lemine 0.5 mg·kg-1,1-3 times per day,intravenous drip on the basis of control group.The two groups were treated for 3 d.The improvement of clinical symptoms were compared between the two groups,the levels of myocardial zymogram and cardiac function were compared before and after treatment between the two groups,the adverse drug reactions of the two groups were recorded during the treatment.Results After treatment,the lactic dehydrogenase(LDH)were(93.04±4.55),(124.73±5.49)U·L-1,creatine kinase(CK)were(86.47±18.46),(113.94±14.66)U·L-1 and creatine kinase isoenzyme(CK-MB)were(33.64±3.56),(38.35±6.53)U·L-1,all with significant difference(all P<0.05).After treatment,the time of cough,wheezing,lung moist rale disappearance and heart failure control time between the two groups were significant(P<0.05).There were no significant differences in the levels of left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular stroke volume(LVSV),left ventricular ejection fraction(LVEF)between the two groups(P>0.05).During the treatment,there were 1 case of oral ulcer and 1 case of diarrhea occurred in control group,the incidence of adverse drug reactions was 5.00%,and there were 1 case of vomiting and 3 cases of diarrhea occurred in treatment group,and the incidence of adverse reactions was 10.00%.There was no significant difference in the incidence of adverse drug reactions between the two groups(P>0.05).Conclusion Dopamine combined with phenol lemine can relieve clinical symptoms and improve myocardial enzyme spectrum more quickly in children with pneumonia and heart failure,and the safety of the treatment is good.