去甲肾上腺素联合米力农治疗脓毒性休克患儿的疗效及对血清α-HBDH PCT hs-CRP的影响

Curative Effect of Norepinephrine Combined with Milrinone in Treating Septic Shock of Children and the Effects on Serum Levels ofα-HBDH PCT Hs-CRP

目的:探讨去甲肾上腺素联合米力农治疗脓毒性休克患儿的疗效及对血清α-羟丁酸脱氢酶(α-HBDH)、降钙素原(PCT)、超敏C反应蛋白(hs-CRP)的影响。方法:选择2017年5月至2019年5月我院收治的脓毒性休克患儿100例进行研究,以简单随机分组法分为观察组(n=51)和对照组(n=49)。对照组给予去甲肾上腺素治疗,观察组采用去甲肾上腺素联合米力农治疗。比较两组患者的临床疗效、血清α-HBDH、PCT、hs-CRP、二氧化碳分压(PaCO2)、pH值、急性生理性与慢性健康状况评分系统Ⅱ(APACHEⅡ)、序贯器官衰竭估计(SOFA)水平变化情况、入住重症监护病房(ICU)时间及28d病死率。结果:治疗后,观察组总有效率为96.08%显著高于对照组的79.59%,差异显著(P<0.05);治疗后,两组血清α-HBDH、PCT、hs-CRP水平均有所改善,且观察组α-HBDH、PCT、hs-CRP水平均显著低于对照组(P<0.05);治疗前,两组血气指标水平无明显差异;治疗后,两组血气指标水平均有所改善,且观察组PaCO2、pH水平均显著低于对照组(P<0.05);治疗后,两组APACHEⅡ、SOFA评分水平均有所改善,且观察组APACHEⅡ、SOFA评分均显著低于对照组(P<0.05);观察组入住ICU时间、28d病死率及总死亡率均显著低于对照组,差异显著(P<0.05)。结论:在脓毒性休克患儿中应用去甲肾上腺素联合米力农效果显著,可有效改善患儿α-HBDH、PCT、hs-CRP水平。

Objective:To study the curative effect of norepinephrine combined with milrinone in treating children with septic shock and the effects on serum levels ofα-hydroxybutyrate dehydrogenase(HBDH),procalcitonin(PCT),hs-CRP.Methods:100 children with septic shock admitted to our hospital from May 2017 to May 2019 were selected for the study,and were divided into the observation group(n=51)and the control group(n=49)by the random number table method.The control group was treated with norepinephrine,and the observation group was treated with norepinephrine and milrinone.The clinical effectiveness,serumα-HBDH,PCT,hs CRP,PaCO2,pH,acute physiological and chronic health status scoring system II(APACHE II),sequential organ failure assessment(SOFA),admission time to intensive care unit(ICU)and 28-day mortality were compared between the two groups.Results:After treatment,the total effective rate of the observation group was 96.08%,significantly higher than that of the control group(79.59%)(P<0.05).After treatment,the serum levels ofα-HBDH,PCT and hs-CRP in both groups were improved,and the serum levels ofα-HBDH,PCT and hs-crp in the observation group were significantly lower than those in the control group(P<0.05).Before treatment,there was no significant difference in blood gas level between the two groups.After treatment,the blood gas indexes of the two groups were improved,and the PaCO2 and pH levels of the observation group were significantly lower than those of the control group(P<0.05).After treatment,APACHEⅡ,SOFA score level of the two groups are improved,and in the observation group,APACHEⅡ,SOFA scores were significantly lower than control group(P<0.05).The ICU admission time,28d mortality and total mortality of the observation group were significantly lower than those of the control group,with significant differences(P<0.05).Conclusion:Norepinephrine combined with milinone has a significant effect on the serum levels ofα-HBDH,PCT and hs-CRP in children with septic shock.