低剂量多巴胺与多巴酚丁胺联用对重症肺炎患儿临床疗效及血清炎症因子的影响

Effects of Low Dose of Dopamine in Combination with Dobutamine on Clinical Efficacy and Serum Inflammatory Factors in Children with Severe Pneumonia

目的:探讨低剂量多巴胺与多巴酚丁胺联用对重症肺炎患儿的临床疗效及血清炎症因子水平的影响。方法:选取2021年1月~2021年12月期间于本院进行重症肺炎治疗的130例患儿作为研究对象,采用随机数字表法分为对照组与研究组,每组65例。对照组采用常规治疗方案,研究组在对照组基础上联用低剂量多巴胺与多巴酚丁胺治疗,两组均治疗5天。比较两组临床疗效、血清炎症因子[白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]、血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、肺功能指标[第1秒用力呼气容积(FEV1)、呼气流量峰值(PEF)、用力肺活量(FVC)]、pH及临床症状及体征改善情况。结果:治疗后,研究组治疗有效率(96.92%)高于对照组(87.69%,P<0.05);两组IL-6、CRP、IL-8及TNF-α等血清炎症因子水平均降低(P<0.05),且研究组各指标水平均低于对照组(P<0.05);两组PaO_(2)、pH均升高(P<0.05),且研究组PaO_(2)、pH均高于对照组(P<0.05);两组PaCO_(2)均降低(P<0.05),且研究组PaCO_(2)低于对照组(P<0.05);研究组肺部啰音、发热及呼吸困难缓解时间均低于对照组(P<0.05);两组FEV1、FVC等肺功能指标均升高(P<0.05),且研究组各指标水平均高于对照组(P<0.05);两组PEF均升高(P<0.05),但两组比较无统计学差异(P>0.05)。结论:常规治疗方案联用低剂量多巴胺与多巴酚丁胺对小儿重症肺炎具有较好的临床疗效,可降低患儿血清炎症因子水平,改善临床症状,提高肺功能,值得临床借鉴。

Objective:To investigate the effects of low dose dopamine in combination with dobutamine on the clinical efficacy and serum inflammatory factors in children with severe pneumonia.Methods:A total of 130 children with severe pneumonia treated in our hospital from January 2021 to December 2021 were enrolled as the study subjects.The patients were randamized into the control group(n=65)and the study group(n=65),the control group used the conventional treatment regimen,and the study group applied low dose dopamine and dobutamine on the basis of the control group,and both groups were treated for 5 days.The clinical efficacy,serum inflammatory factors[interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),C reactive protein(CRP)],blood gas indexes[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))],pulmonary function indexes[forced expiratory volume in one second(FEV1),peak expiratory flow(PEF),forced vital capacity(FVC)],pH and improvement of clinical symptoms and signs were compared between the two groups.Results:After treatment,the effective rate of 96.92%in study group was significantly higher than 87.69%in control group(P<0.05);the levels of serum inflammatory factors IL-6,CRP,IL-8 and TNF-αin the two group were significantly lower(P<0.05),and the level of all indexes in the study group were lower than those of the control group(P<0.05);PaO_(2)and pH increased in both groups(P<0.05),and PaO_(2)and pH in the study group were higher than those in the control group(P<0.05);the PaCO_(2)decreased in both groups(P<0.05),and the PaCO_(2)in the study group was lower than that in the control group(P<0.05);the remission time of pulmonary rales,fever and dyspnea in the study group were significantly lower than those in the control group(P<0.05);FEV1 and FVC increased in both groups(P<0.05),and the levels of all indexes in the study group were higher than those in the control group(P<0.05);PEF increased in both groups(P<0.05),but no statistical difference between the two groups was observed(P>0.05).Conclusion:The conventional treatment regimen combined with low dose dopamine and dobutamine can bring a good clinical effects on pediatric severe pneumonia,which can reduce the level of serum inflammatory factors in children,improve clinical symptoms and lung function,which is worthy of clinical reference.