小剂量左西孟旦对老年脓毒症患者死亡率和器官功能的影响  

Effect of low-dose levosimendan on mortality and organ function of elderly patients with sepsis

作　　者：李晶[1] 杨杰[2] 王晓英[3] 原平[1] 张鹏 柴巧英[4] 杨智勇 LI Jing;YANG Jie;WANG Xiao-ying;YUAN Ping;ZHANG Peng;CHAI Qiao-ying;YANG Zhi-yong(Department of General Medicine,Hebei University of Engineering Affiliated Hospital,Handan 056002,China;Department of Endocrinology,Hebei University of Engineering Affiliated Hospital,Handan 056002,China;Department of Nephrology,Hebei University of Engineering Affiliated Hospital,Handan 056002,China;Department of Fourth Cardiology,the First Hospital of Handan City,Handan 056000,China;Department of Second Oncology,Handan Center Hospital,Hanhan 056001,China)

机构地区：[1]河北工程大学附属医院全科医学科,河北邯郸056002 [2]河北工程大学附属医院内分泌科,河北邯郸056002 [3]河北工程大学附属医院肾内科,河北邯郸056002 [4]邯郸市第一医院心内四科,河北邯郸056000 [5]邯郸市中心医院肿瘤二科,河北邯郸056001

出　　处：《实用药物与临床》2018年第12期1373-1376,共4页Practical Pharmacy and Clinical Remedies

基　　金：河北省医学科学研究重点课题计划(20180795)

摘　　要：目的评估老年脓毒症患者使用小剂量左西孟旦[0. 1～0. 2μg/(kg·min)]对死亡率和器官功能的影响。方法采用回顾性、随机、双盲设计,收集2014年1月至2017年12月我院ICU收治的168例年龄≥65岁的感染性休克患者作为研究对象。采用计算机进行随机区组设计,将所有患者随机平均分为左西孟旦组(84例)和对照组(84例)。对照组给予标准治疗,左西孟旦组在标准治疗的基础上连续静脉输注0. 1～0. 2μg/(kg·min)左西孟旦(规格:5 ml/12. 5 mg) 24 h,无负荷剂量。记录患者给药后28 d内平均每日连续器官衰竭评估(Sequential organ failure assessment,SOFA)评分,比较两组患者ICU住院死亡率、住院期间死亡率、28 d内患者死亡率,以及ICU住院天数、总住院天数。结果左西孟旦组和对照组患者在ICU住院死亡率、住院期间死亡率、28 d内患者死亡率、平均每日SOFA得分以及除心血管评分之外的其他器官评分方面差异均无统计学意义(P> 0. 05)。左西孟旦组患者的ICU住院天数、总住院天数较对照组缩短,而心血管器官衰竭评分高于对照组,差异均有统计学意义(P <0. 05)。结论小剂量左西孟旦能缩短ICU住院天数和总住院天数,并能改善患者的心血管功能,对于老年脓毒症患者有应用价值。Objective To evaluate the effect of low-dose levosimendan[0.1-0.2μg/(kg·min)]on mortality and organ functions in elderly patients with sepsis.Methods A retrospective,randomized and double-blinded design was used.Totally168patients with sepsis shock older than65years old in the intensive care unit(ICU)of our hospital from January2014to December2017were collected.All patients were randomly divided into levosimendan group(n=84)and control group(n=84).Control group was given standard treatment,and levosimendan group was administered levosimendan(specification:5ml/12.5mg)at a continuous intravenous infusion rate of0.1-0.2μg/(kg·min)(without a loading dose)in addition to the standard treatment.The average daily sequential organ failure assessment(SOFA)scores within28d after medication were recorded.The ICU and in-hospital mortality and the mortality of patients within28d,and the duration of ICU and hospital stay between the two groups were compared.Results There was no significant difference in ICU and in-hospital mortality or the mortality of patients within28d or average daily SOFA score or all the organ scores,except cardiovascular scores,between the two groups(P<0.05).The duration of ICU and hospital stay in levosimendan group was shorter than those of control group(P<0.05),and the score of cardiovascular failure in levosimendan was higher(P<0.05).Conclusion Low-dose levosimendan shortens the duration of ICU and hospital stay and improves the cardiovascular function,which can be applied to elderly patients with sepsis.

关 键 词：左西孟旦 老年人 脓毒血症 死亡率 

分 类 号：R459.7[医药卫生—急诊医学]