间羟胺与去甲肾上腺素治疗成人脓毒性休克的疗效对比以及对肾功能的影响  

Comparison of the Therapeutic Efficacy of Metaraminol and Norepinephrinein Treating Adult Septic Shock and Their Impact on Renal Function

作　　者：鲜蓉梅 匡微 苏亚东 邓松 Xian Rongmei(Department of Pharmacy,Nanchong Physical and Mental Hospital,Affiliated to North Sichuan Medical College,Nanchong Sichuan 637700)

机构地区：[1]川北医学院附属南充市身心医院药剂科,四川南充637700

出　　处：《黑龙江医药》2025年第1期51-54,共4页Heilongjiang Medicine journal

基　　金：南充市科技计划项目(项目编号:21YFZJZC0001);项目名称:间羟胺与去甲肾上腺素对成人脓毒性休克患者临床疗效的对比研究。

摘　　要：目的:探究间羟胺与去甲肾上腺素在治疗成人脓毒性休克过程中的临床疗效对比以及对患者肾功能的影响。方法:将符合纳入排除标准的82例入组病例根据使用去甲肾上腺素或间羟胺抗休克治疗的不同分为去甲肾组(n=54)和间羟胺组(n=28),观察与对比两组患者经治疗前后血流动力学相关指标、肾功能指标、血乳酸水平以及28天内生存情况、平均住院天数、心律失常发生次数等情况。结果:间羟胺组患者较去甲肾组在治疗后仅在治疗后4天、7天两组患者的HR、MAP、CVP、Lac的血流动力学相关指标差异存在统计学意义(P<0.05),在治疗后10天、14天、20天、28天血流动力学相关指标趋近,差异无统计学意义(P>0.05)。两组患者肾功能指标逐步恢复,两组患者的SCr、BUN均逐步降低,尿量均逐步增加,且均较治疗前差异具有统计学意义(P<0.05);间羟胺组患者较去甲肾组在治疗后4天、7天、10天、14天、20天、28天的SCr、BUN改善更佳,尿量恢复更好,两组差异有统计学意义(P<0.05)。与去甲肾组对照,间羟胺组患者较去甲肾组的28天生存率稍高,住院时间稍长,但差异无统计学意义(P>0.05),间羟胺组患者心律失常发生率更低,差异有统计学意义(P<0.05)。结论:在脓毒性休克患者的休克解除与血流动力学稳定中,间羟胺与去甲肾上腺素的临床效应相近,但对于改善和保护患者肾功能间羟胺具备一定优势。Objective:To explore the clinical efficacy of metaraminol and norepinephrine in the treatment of adult septic shock and their effects on renal function.Methods:82 cases that met the inclusion and exclusion criteria were divided into two groups based on the use of norepinephrine or metaraminol for anti-shock treatment:the norepinephrine group(n=54)and the metaraminol group(n=28).The hemodynamic parameters,renal function indicators,blood lactate levels,and survival status within 28 days,average length of hospital stay,and incidence of arrhythmia were observed and compared between the two groups before and after treatment.Results:Compared with the norepinephrine group,the patients in the metaraminol group showed statistically significant differences in the hemodynamic parameters of HR,MAP,CVP,and Lac on days 4 and 7 after treatment(P<0.05).However,the hemodynamic parameters tended to converge on days 10,14,20,and 28 after treatment,with no statistically significant differences(P>0.05).The renal function indicators of both groups gradually recovered,with SCr and BUN gradually decreasing and urine output gradually increasing,and both groups showed statistically significant differences compared with those before treatment(P<0.05);The improvement of SCr and BUN,as well as the recovery of urine volume,were better in the metaraminol group than in the norepinephrine group on days 4,7,10,14,20,and 28 after treatment,and the difference between the two groups was statistically significant(P<0.05).Compared with the norepinephrine group,the 28-day survival rate of patients in the metaraminol group was slightly higher,and the length of hospital stay was slightly longer,but the difference was not statistically significant(P>0.05).The incidence of arrhythmia in patients in the metaraminol group was lower,and the difference was statistically significant(P<0.05).Conclusion:In the treatment of septic shock patients,the clinical effects of metaraminol and norepinephrine are similar in terms of shock relief and hemodynamic stability,bu

关 键 词：脓毒性休克 去甲肾上腺素 间羟胺 血流动力学 肾功能 

分 类 号：R631.2[医药卫生—外科学]