去甲肾上腺素联合乌司他丁治疗脓毒症患儿的效果

Effects of norepinephrine combined with Ulinastatin in treatment of children with sepsis

目的:观察去甲肾上腺素联合乌司他丁治疗脓毒症患儿的效果。方法:选取2020年1月至2022年1月该院收治的120例脓毒症患儿进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各60例。两组均接受抗感染治疗,在此基础上,对照组接受乌司他丁治疗,观察组在对照组基础上联合去甲肾上腺素治疗,比较两组治疗前后炎性因子[血清降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)]水平、序贯器官衰竭估计评分(SOFA)评分、急性生理学与慢性健康状况评价Ⅱ(APACHEⅡ)评分、心肌损伤标志物[脑钠肽(BNP)、心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶MB(CK-MB)]水平和心功能指标[左心室射血分数(LVEF)、二尖瓣舒张早期充盈速度E峰/心房收缩期最大流速A峰(E/A)]水平。结果:治疗后,观察组PCT、TNF-α、BNP、cTnI、CK-MB水平均低于对照组,差异有统计学意义(P<0.05);治疗后,观察组SOFA、APACHEⅡ评分均低于对照组,LVEF、E/A水平均高于对照组,差异有统计学意义(P<0.05)。结论:去甲肾上腺素联合乌司他丁治疗脓毒症患儿可降低炎性因子、心肌损伤标志物水平,SOFA和APACHEⅡ评分,提高心功能指标水平,效果优于单纯乌司他丁治疗。

Objective:To observe effects of norepinephrine combined with Ulinastatin in treatment of children with sepsis.Methods:A prospective study was conducted on 120 children with sepsis admitted to this hospital from January 2020 to January 2022.They were divided into control group and observation group according to the random number table method,60 cases in each group.Both groups received anti-infection treatment.On this basis,the control group was treated with Ulinastatin,while the observation group was treated with norepinephrine on the basis of that of the control group.The levels of inflammatory factors[serum procalcitonin(PCT),tumor necrosis factor-α(TNF-α)],the sequential organ failure assessment(SOFA)score,the acute physiology and chronic health evaluation(APACHEⅡ)score,the myocardial injury marker levels[B-type natriuretic peptide(BNP),cardiac troponin I(cTnI),creatine kinase isoenzymeⅡ(CK-MB)],and the cardiac function index levels[left ventricular ejection fraction(LVEF),early diastolic filling velocity of mitral valve peak E/atrial systolic peak A maximum velocity(E/A)]were compared between the two groups before and after the treatment.Results:After the treatment,the levels of PCT,TNF-α,BNP,cTnI and CK-MB in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the scores of SOFA and APACHE II in the observation group were lower than those in the control group,the levels of LVEF and E/A were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusions:Norepinephrine combined with Ulinastatin in the treatment of the children with sepsis can reduce the levels of inflammatory factors,myocardial injury markers,SOFA scores and APACHE II scores,and improve the levels of cardiac function indexes.Moreover,it is superior to single Ulinastatin treatment.