小剂量多巴胺联用酚妥拉明治疗原发性肾病综合征患儿水肿的临床研究  

Combined application of low-dose dopamine and phentolamine for treatment of edema in children with nephrotic syndrome

作　　者：洪建东[1] 王明峰[2] 付清流[1] 郑天文[1] 苏志强[1] 习战榕[1] 

机构地区：[1]福建泉州市儿童医院,362000 [2]福建省安溪县医院,362400

出　　处：《中国小儿急救医学》2011年第1期36-38,共3页Chinese Pediatric Emergency Medicine

摘　　要：目的探讨小剂量多巴胺联用等量酚妥拉明对原发性肾病综合征（PNS）患儿水肿的疗效及安全性。方法采取回顾性对照研究的方法。在常规综合治疗的基础上，对155例PNS并发水肿患儿（联用治疗组）给予小剂量多巴胺联用等量酚妥拉明治疗，并与128例单用呋塞米患儿（呋塞米治疗组）对照。结果联用治疗组治疗后尿量、尿钠均高于治疗前，差异有显著性（P〈0．01），而血钾、血钠及尿钾虽高于治疗前，但差异无显著性（P〉0．05）。呋塞米治疗组治疗后尿量、尿钾、尿钠均高于治疗前，差异有显著性（P〈0．01），而血钾、血钠均低于治疗前，差异有显著性（P〈0．01）。联用治疗组治疗后水肿减轻率、尿量、尿钠、血钾及血钠均高于呋塞米治疗组，差异有显著性（P〈0．01）；而尿钾低于呋塞米治疗组，差异有显著性（P〈0．05）。治疗后药物不良反应发生率方面，联用治疗组低于呋塞米治疗组，差异有显著性（P〈0．01）。结论小剂量多巴胺联用等量酚妥拉明治疗小儿PNS水肿安全、有效，适用于不同血容量状态的患儿，可替代呋塞米等利尿剂作为一线用药。Objective To explore the efficacy and safety of low dose dopamine combined with phentolamine in the treatment of primary nephrotic syndrome （PNS） with edema. Methods Retrospective control studies were performed in 155 patients of PNS with edema, who received comprehensive treatment with small dose dopamine combined with phentolamine （group A）. Patients treated with furosemide infusion were recruited as control （ group B ）. Results The urinary output, urinary sodium increased after therapy in group A, showing significant differences （P 〈 0. 01 ）. But urinary potassium excretion, serum sodium and potassium showed no significant difference after therapy in group A. The urinary output, urinary sodium and potassium excretion increased and the serum sodium and potassium decreased after therapy in group B, all showing significant differences between before and after treatment （P 〈 0. 01 ）. The edema relief rate, urinary output, urinary sodium excretion, serum sodium and potassium in group A was significantly higher whereas urinary potassium excretion were significantly lower than those of group B （ P 〈 0. 01 ）. The rate of drug adverse reaction in group A was significantly lower than that of group B. Conclusion Low dose dopamine combined with phentolarnine in PNS with edema is safe and effective, which may be a substitute of diuretic like furosemide in the treatment of edema of patients with different blood volume.

关 键 词：小剂量多巴胺 酚妥拉明 原发性肾病综合征 水肿 儿童 

分 类 号：R726.9[医药卫生—儿科]