| 张向峰,靳秀红.多巴胺联合美托洛尔治疗小儿肺炎合并心力衰竭66例的疗效及对心脏结构的影响[J].安徽医药,2018,22(7):1388-1391. |
| 多巴胺联合美托洛尔治疗小儿肺炎合并心力衰竭66例的疗效及对心脏结构的影响 |
| The effect of dopamine combined with metoprolol in the treatment of pneumonia complicated with heart failure and its influence on cardiac structure |
| 投稿时间：2017-06-30 |
| DOI： |
| 中文关键词: 肺炎, 细菌性 心力衰竭 多巴胺 美托洛尔 乳酸脱氢酶类 肌酸激酶 儿童 |
| 英文关键词: Pneumonia, bacterial Heart failure Dopamine Metoprolol Lactate dehydrogenases Creatine kinase Child |
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| 中文摘要: |
| 目的 探讨多巴胺联合美托洛尔治疗小儿肺炎合并心力衰竭的疗效及对心脏结构的影响。方法 选取2014年8月至2016年10月收治的小儿肺炎合并心力衰竭患儿132例,根据随机数字表法分为对照组和联合组,每组66例。对照组患儿进行常规抗感染、镇静、强心、利尿等治疗,联合组患儿在对照组基础上给予静脉滴注多巴胺联合口服美托洛尔治疗。观察并比较两组患儿临床体征改善时间、治疗前后心率、呼吸、血氧饱和度、心肌酶情况、心脏结构情况及不良反应情况。结果 两组患儿治疗后心率和呼吸次数较治疗前降低,血氧饱和度较治疗前上升(P<0.05)。联合组患儿治疗后心率(94.67±5.20)次/分钟和呼吸次数(29.68±3.36)次/分钟低于对照组治疗后,血氧饱和度(98.68±2.59)%高于对照组治疗后(t=17.681、22.156、6.179；P<0.05)。联合组患儿体征改善时间分别是呼吸平稳(1.78±0.68) d、心率平稳(2.03±0.41) d、肺啰音消失(4.68±1.15) d、心力衰竭纠正(4.16±1.23) d、肝脏回缩(3.30±0.59) d住院时间(7.54±1.65) d均短于对照组患儿(t=18.347、21.850、19.263、8.325、22.216、5.732；P<0.05)。两组患儿治疗后LDH(乳酸脱氢酶,lactate dehydrogenase)、CK(肌酸激酶,creatine kinase)及CK-MB(肌酸激酶同工酶,creatine kinase isoenzymes)同工酶水平均较治疗前降低(P<0.05) 。联合组患儿治疗后LDH(91.36±3.69)U·L-1、CK(82.36±15.84)U·L-1及CK-MB(31.05±3.96)U·L-1水平低于对照组治疗后(t=30.284、10.931、16.293；P<0.05)。两组患儿治疗后LVEDD、LVESD、LVSV及LVEF水平与治疗前比较差异无统计学意义(P>0.05)。两组患儿不良反应发生情况比较,差异无统计学意义(联合组6.06%比对照组4.55%,P>0.05)。结论 多巴胺联合美托洛尔治疗小儿肺炎合并心力衰竭可有效降低患儿心率和呼吸频率,改善临床体征和心肌酶水平,不良反应少,安全性高。 |
| 英文摘要: |
| Objective To investigate the effect of dopamine combined with metoprolol in the treatment of pneumonia complicated with heart failure in children and its influence on cardiac structure. Methods 132 cases of children with pneumonia complicated with heart failure from August 2014 to October 2016 in our hospital, randomly divided into control group and combination group, with 66 in each group. The control group with conventional anti infection, calm, strong heart, diuretic therapy, combined with patients in the control group were given dopamine combined with metoprolol. The clinical signs were compared between the two groups were observed before and after treatment and improvement time, heart rate, respiration, blood oxygen saturation, myocardial enzymes, cardiac structure and adverse reaction. Results After treatment, the heart rate and respiratory frequency of the two groups were lower than those before treatment, and the blood oxygen saturation was higher than that before treatment (P<0.05). After treatment, the heart rate (94.67±5.20 min-1) and respiratory frequency (29.68 ±3.36) were significantly lower in the combined group than those in the control group (P<0.05), and the blood oxygen saturation was (98.68±2.59)% higher than that in the control group (P<0.05). In the combined group, the respiratory stability was (1.78±0.68) μ m, the heart rate was (2.03±0.41) g, and the lung rale disappeared (4.68±1.15) g, (4.16±1.23) m, (3.30±0.59) and hospitalization time were shorter than those in the control group (P<0.05). LDH (lactate dehydrogenase) and creatine kinase (CK) and creatine kinase isoenzyme (creatine kinase) . The levels of tine kinase isozymes were significantly lower than those before treatment (P<0.05). The levels of LDH (91.36±3.69 U·L-1 CK(82.36±15.84)U·L-1 and CK-MB (31.05±3.96) U·L-1 in the combined group after treatment were lower than those in the control group (P<0.05). There was no statistical difference in LVSV and LVEF levels between the two groups after treatment (P>0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05)(6.6% vs 4.55%,P>0.05). Conclusions Children can effectively reduce the heart rate and respiratory rate of dopamine combined with metoprolol in the treatment of infantile pneumonia complicated by heart failure, improve the clinical signs and myocardial enzyme levels, less adverse reaction, high safety. |
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