连续性肾替代疗法联合去甲肾上腺素治疗对感染性休克患者血流动力学指标的影响  

The Effect of Continuous Renal Replacement Therapy Combined with Norepinephrine Treatment on Hemodynamic Indicators in Patients with Septic Shock

作　　者：叶家茂 YE Jiamao(Department of Critical Care Medicine,Yangzhou Traditional Chinese Medicine Hospital,Yangzhou 225000,Jiangsu,China)

机构地区：[1]扬州市中医院重症医学科,江苏扬州225000

出　　处：《系统医学》2025年第3期70-73,共4页Systems Medicine

摘　　要：目的探讨连续性肾替代疗法联合去甲肾上腺素治疗对感染性休克患者血流动力学指标的影响。方法非随机选取扬州市中医院于2020年1月—2024年1月确诊的93例感染性休克患者为研究对象,根据治疗方式不同分为对照组(n=46)和观察组(n=47)。对照组接受连续性肾替代疗法,观察组在对照组的基础上联合去甲肾上腺素治疗。对比两组患者的炎症因子[白细胞介素6(interleukin 6,IL-6)、C反应蛋白(C-reactive protein,CRP)]、血流动力学[心率(heart rate,HR)、平均动脉压(mean arterial pressure,MAP)、心排出指数(cardiac index,CI)]以及肾功能指标(血肌酐、尿素氮水平)。结果治疗后观察组的IL-6、CRP水平分别为(64.62±5.53)ng/mL、(104.68±10.56)mg/L,均低于对照组的(68.34±6.57)ng/mL、(115.74±11.27)mg/L,差异有统计学意义(t=2.957、4.885,P均<0.05)。治疗后观察组的HR、血肌酐和尿素氮水平低于对照组,MAP和CI高于对照组,差异有统计学意义(P均<0.05)。结论感染性休克患者在连续性肾替代疗法基础上联合去甲肾上腺素治疗,能够促进炎症因子水平降低,有效改善血流动力学指标,提升肾功能。Objective To explore the effect of continuous renal replacement therapy combined with norepinephrine treatment on hemodynamic indicators in patients with septic shock.Methods A total of ninety-three patients with septic shock diagnosed in Yangzhou Traditional Chinese Medicine Hospital from January 2020 to January 2024 were nonrandomly selected as the research objects.According to different treatment methods,they were divided into control group(n=46)and observation group(n=47).The control group received continuous renal replacement therapy,and the observation group was treated with norepinephrine on the basis of the control group.The inflammatory factors[interleukin 6(IL-6),C-reactive protein(CRP)],hemodynamics[heart rate(HR),mean arterial pressure(MAP),cardiac index(CI)]and renal function indexes(serum creatinine,urea nitrogen levels)were compared between the two groups.Results After treatment,the levels of IL-6 and CRP in the observation group were(64.62±5.53)ng/mL and(104.68±10.56)mg/L,which were lower than in(68.34±6.57)ng/mL and(115.74±11.27)mg/L in the control group,and the differences were statistically significant(t=2.957,4.885,both P<0.05).After treatment,HR,serum creatinine and urea nitrogen in the observation group were lower than those in the control group,MAP and CI were higher than those in the control group,and the differences were statistically significant(all P<0.05).Conclusion Patients with septic shock combined with norepinephrine on the basis of continuous renal replacement therapy can promote the reduction of inflammatory factors,effectively improve hemodynamic indexes and improve renal function.

关 键 词：连续性肾替代疗法 去甲肾上腺素 感染性休克 血流动力学 炎症因子 肾功能 

分 类 号：R4[医药卫生—临床医学]