摘要
目的 :探讨血管活性药物对脓毒症患者肝、肾功能的影响。方法 :回顾性研究 1997年 1月— 2 0 0 1年6月外科 ICU内使用血管活性药物超过 4日的脓毒症患者 ,记录用药前 1日的急性生理学和慢性健康状况评分 (APACHE )、体循环平均动脉压等资料。患者分为大剂量多巴胺组、去甲肾上腺素加用小剂量多巴胺或多巴酚丁胺组及小剂量多巴胺或多巴酚丁胺组 ,比较用药前后血肌酐及总胆红素的变化。结果 :大剂量多巴胺组用药后血肌酐及总胆红素均显著增高 (P<0 .0 1和 P<0 .0 5 )。去甲肾上腺素加用小剂量多巴胺或多巴酚丁胺对血肌酐及总胆红素均无显著影响。单用小剂量多巴胺或多巴酚丁胺可使血肌酐显著降低 ,但用药前后血总胆红素无显著差异。结论 :使用小剂量多巴胺或多巴酚丁胺可能对脓毒症患者肝、肾等脏器的血液循环有利 ,可以逆转用去甲肾上腺素升压时对内脏灌流的不良影响。
Objective:To investigate effects of vasoactive agents on liver and renal function in septic patients.Methods:The data of sepsis or septic shock patients from January,1997 to June,2001 received vasoactive agents for more than 4 days were analyzed.Acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) scores and mean arterial blood pressure in these patients before and during vasoactive agents administration were recorded.Patients were assigned into three groups:group of using highdose dopamine only,group of norepinephrine combined with lowdose dopamine or dobutamine,and group of lowdose dopamine or dobutamine only.Changes in serum levels of creatinine and total bilirubin in patients were compared.Results:Highdose dopamine significantly increased serum levels of creatinine and total bilirubin( P <0 01 and P <0 05).Norepinephrine combined with lowdose dopamine or dobutamine did not make significant changes in serum levels of both creatinine and total bilirubin.However,lowdose dopamine or dobutamine markly decreased serum creatinie level,without influence on serum level of total bilirubin.Conclusions:Lowdose dopamine or dobutamine may be benefit for the vital organ circulation such as liver and kidneys in septic patients,and may reverse norepinephrine′s harmful effects on the splanchnic perfusion.
出处
《中国危重病急救医学》
CAS
CSCD
2002年第5期276-278,共3页
Chinese Critical Care Medicine
基金
全军"十.五"医药科研基金资助项目 (No.0 1L0 81)
