小剂量多巴胺联合磷酸肌酸钠治疗小儿肺炎并心力衰竭临床研究

Low Dose Dopamine Combined with Creatine Phosphate for Children with Pneumonia Complicated with Heart Failure

目的探讨小剂量多巴胺联合磷酸肌酸钠治疗小儿肺炎并心力衰竭(简称心衰)的临床疗效及对胰岛素样生长因子1(IGF-1)、D-二聚体(D-D)、心肌肌钙蛋白I(cTnI)、血清降钙素原(PCT)水平的影响。方法选取医院2017年6月至2019年6月收治的肺炎并心衰患儿98例,按奇偶数法分为观察组和对照组,各49例。两组患儿均予常规治疗,并予注射用磷酸肌酸钠,观察组患儿加用小剂量盐酸多巴胺注射液。两组均连续治疗7 d。结果观察组总有效率为89.80%,显著高于对照组的73.47%(P<0.05);与治疗前比较,两组患儿治疗后的左室射血分数(LVEF)显著升高,左室收缩末内径(LVESd)、左室舒张末内径(LVEDd)、QT间期离散度(QTd)及IGF-1、D-D,cTnI,PCT水平均显著降低,且观察组患者上述指标改善程度均显著优于对照组(P<0.05);观察组与对照组不良反应发生率相当(18.37%比10.20%,χ2=1.333,P=0.248>0.05)。结论小剂量多巴胺联合磷酸肌酸钠治疗小儿肺炎并心衰,能改善患儿的心功能,降低各项血清生物学指标水平。

Objective To investigate the clinical efficacy of low dose dopamine combined with creatine phosphate for children with pneumonia complicated with heart failure and its influence on the levels of insulin-like growth factor-1(IGF-1),D-dimer(D-D),cardiac troponin I(cTnI)and procalcitonin(PCT).Methods A total of 98 children with pneumonia complicated with heart failure in the hospital from June 2017 to June 2019 were selected and divided into the observation group and control group according to the odd or even number of visits,49 cases in each group.Both groups were given routine treatment and creatine phosphate injuection,while the observation group was added with low dose dopamine injection.All patients were treated for a continuous 7 d.Results The total effective rate of the observation group was 89.80%,which was higher than 73.47%of the control group(P<0.05).Compared with before treatment,the levels of left ventricular ejection fraction(LVEF)in the two groups were significantly higher,the levels of left ventricular end systolic diameter(LVESd),left ventricular end diastolic diameter(LVEDd),and QT interval dispersion(QTd)were significantly lower,and the improvements int the observation group were better than those in the control group(P<0.05).The incidence of adverse reactions in observation group and control group were similar(18.37%vs.10.20%,χ~2=1.333,P=0.248>0.05).Conclusion Low dose dopamine combined with creatine phosphate for children with pneumonia complicated with heart failure can improve children’s cardiac function and reduce the level of serum markers.