垂体后叶素在感染性休克中对乳酸清除率及预后的影响  

Influence of the pituitrin on lactate clearance rate and OutCome of septic shock

作　　者：黄晓英[1] 韩旭东[1] 张素燕[1] 王亚东[1] 任轲[1] 田李均[1] 徐俊贤[1] 

机构地区：[1]南通市第三人民医院重症医学科,江苏南通226006

出　　处：《中国急救医学》2012年第3期206-208,共3页Chinese Journal of Critical Care Medicine

基　　金：江苏省南通市科委课题（No.S9913）

摘　　要：目的探讨垂体后叶素（pituitrin）对感染性休克患者乳酸清除率及预后的影响。方法对101例感染性休克患者在给予儿茶酚胺类药物提升血压基础上，随机分两组加用或不加用垂体后叶素治疗，比较两组间儿茶酚胺类药物剂量、血乳酸清除率及28d死亡率。结果垂体后叶素组与对照组相比，去甲。肾上腺素剂量减少（P=0．015），24h后高乳酸清除率比率显著高于后者（X2=5．749，P=0．026）。垂体后叶素组与对照组28d死亡率差异无统计学意义（X^2=0．387，P=0．551）；以乳酸清除率10％为界分析显示：乳酸清除率≥10％时，两组间差异有统计学意义（X^2=5．205，P=0．027）。乳酸清除率〈10％时，两组间差异无统计学意义（X^2：4．643，P=0．054）。结论垂体后叶素可减少去甲肾上腺素剂量，不引起体内乳酸增高，增加乳酸清除，高乳酸清除率比率显著高于对照组；对于高乳酸清除率者，与对照组相比可降低28d死亡率。To evaluate the influettce of pituitrin on lactate clearance rate and outcome of septic shock. Methods 101 patients with septic shock were randomly divided into two groups： pituitrin group and nonpituitrin group, lactate clearance rate, norephinephrine dosage and mortality were compared in two groups. Results After the treatment, parameters were compared between pituitrin group and control group： Norephinephrine dosage of pituitrin group was lower （P = 0. 015） ;24 h high lactate clearance rate was higher（X^2 =5.749,P =0. 026） ; the mortality of pituitrin group and the control group were 45.24% and 49.15% respectively （X^2 = 0. 387, P = 0. 551 ） ; the pituitrin reduced significantly the mortality in the patients whose lactate clearance rate was more than 10% （X^2 = 5. 205, P = 0. 027 ）. Conclusion Lowdose pituitrin combined with catecholamine can decrease norephinephrine dosage, increase lactate clearance rate. In the patients whose lactate clearance rate was more than 10% ,lowclose pituitrin can reduce the mortality.

关 键 词：垂体后叶素 感染性休克 乳酸清除率 死亡率 

分 类 号：R571.305[医药卫生—消化系统]