垂体后叶素联合小剂量糖皮质激素治疗儿童感染性休克临床疗效及对患儿血清炎性标志物水平的影响

Clinical efficacy of hypophysin combined with low-dose glucocorticoids in the treatment of septic shock and its effect on serum infection markers

目的探讨垂体后叶素联合小剂量糖皮质激素治疗儿童感染性休克临床疗效及对患儿血清炎性标志物水平的影响.方法将90例感染性休克患儿按照随机数字表法分为治疗组与对照组,每组45例.两组均给予常规治疗及垂体后叶素治疗,治疗组在此基础上联合小剂量氢化可的松静脉滴注.比较两组患儿重症加强护理病房住院时间、垂体后叶素使用时间,比较治疗前后两组乳酸水平、降钙素原、C反应蛋白、前白蛋白水平及急性生理功能和慢性健康状况评分系统Ⅱ评分,比较两组不良反应发生率.结果治疗组重症加强护理病房住院时间及垂体后叶素使用时间均显著短于对照组(P<0.01).治疗后两组乳酸水平及急性生理功能和慢性健康状况评分系统Ⅱ评分均显著低于治疗前(P<0.01),治疗组较对照组下降更显著(P<0.01).治疗后两组降钙素原及C反应蛋白水平均较治疗前显著下降(P<0.01),前白蛋白水平较治疗前显著升高(P<0.01),治疗组较对照组变化更显著(P<0.01).治疗组不良反应发生率显著低于对照组(P<0.05).结论小剂量糖皮质激素联合垂体后叶素治疗感染性休克患儿疗效显著,能够缩短重症加强护理病房住院时间,降低乳酸及血清炎性标志物水平,安全性高.

Objective To explore the efficacy of hypophysin combined with low-dose glucocorticoids in the treatment of septic shock and its effect on serum infection markers.Methods 90 cases of children patients with septic shock were divided into treatment group and control group,45 cases each.Both groups were given conventional treatment and treatment with hypophysin.The treatment group was combined with a small dose of hydrocortisone intravenous infusion on this basis.The hospitalization time and the use time of vasopressin in the intensive care unit were compared between the two groups.The lactic acid levels,procalcitonin,Creactive protein,prealbumin levels,acute physiological functions and chronic health status scoring system II scores were compared between the two groups.The incidence of adverse reactions was compared between the two groups.Results The duration of ICU stay and the use time of hypophysin in the treatment group were significantly shorter than those in the control group(P<0.01).The lactic acid level and APAC HE II scores of the two groups were significantly lower than those before treatment(P<0.01),and the treatment group decreased more significantly than the control group(P<0.01).After treatment,the PCT and CRP levels in the two groups were significantly lower than those before treatment(P<0.01),and the PA level was significantly higher than before treatment(P<0.01).The treat-ment group was more significant than the control group(P<0.01).The incidence of adverse reactions in the treatment group was significantly lower than that in the control group(P<0.05).Conclusions Low-dose glucocorticoid combined with hypophysin is effective in the treatment of children with septic shock.It can shorten the leng th of hospitalization in intensive care units,reduce the levels of lactic acid and serum infection markers,and has high safety.