CAJ | 학술논문

目的观察低浓度去甲肾上腺素(NE)对感染性休克患者肾脏血流灌注的影响.方法 74例感染性休克患者经过积极的液体复苏后,使用NE进行治疗,NE最大泵注速率为0.01～0.1μg/(kg·min),微量泵经中心静脉泵入NE的速度从0.01μg/(kg·min)开始,视血压情况逐渐调节药物输注量,直至平均动脉压(MAP)达到75 mmHg.在治疗前对所有休克患者进行急性生理学与慢性健康状况评分系统(APACHE Ⅲ)评分,记录其BP、HR变化及尿量、血尿素氮(BUN)和肌酐(CRE)、尿白蛋白(ALB)和β2-微球蛋白(β2-MG)定量等肾功能指标变化.结果抗休克治疗前,所有患者BUN、CRE、尿ALB和β2-MG定量均异常升高.抗休克治疗开始后,与治疗前相比,患者尿量(UO)、BUN和CRE、尿ALB和β2-MG定量逐步恢复.结论低浓度的去甲肾上腺素能改善感染性休克患者血压,改善肾脏血流灌注.
목적 관찰저농도거갑신상선소(NE)대감염성휴극환자신장혈류관주적영향.방법 74례감염성휴극환자경과적겁적액체복소후,사용NE진행치료,NE최대빙주속솔위0.01～0.1μg/(kg·min),미량빙경중심정맥빙입NE적속도종0.01μg/(kg·min)개시,시혈압정황축점조절약물수주량,직지평균동맥압(MAP)체도75 mmHg.재치료전대소유휴극환자진행급성생이학여만성건강상황평분계통(APACHE Ⅲ)평분,기록기BP、HR변화급뇨량、혈뇨소담(BUN)화기항(CRE)、뇨백단백(ALB)화β2-미구단백(β2-MG)정량등신공능지표변화.결과 항휴극치료전,소유환자BUN、CRE、뇨ALB화β2-MG정량균이상승고.항휴극치료개시후,여치료전상비,환자뇨량(UO)、BUN화CRE、뇨ALB화β2-MG정량축보회복.결론 저농도적거갑신상선소능개선감염성휴극환자혈압,개선신장혈류관주.
Objective To observe the effect of low-dose norepinephrine (NE) on the renal peffusion in patients with septic shock. Methods A total of 74 patients with septic shock were treated with the highest infusing rate of NE at its dosage was adjusted according to patients' blood pressure, until the mean arterial pressure reach 75 mmHg. All the testedpatients were scored by acute physiology and chronic health evaluation (APACHE Ⅲ) system. The APACHE Ⅲ score and the changes in arterial blood pressure, heart rate (HR), urinary output, blood urea nit rogen (BUN), creatinine (CRE), urinary albumin (ALB), and β2-microglobulin (β2-MG) were recorded. Results The abnormally increased level of BUN, CRE, urine ALB, and β2-MG output occurred in all patients before they treated with the anti-shock therapy. During anti-shock treatment, urine output, BUN, CRE, urine ALB, and β2-MG output were decreased gradually. Conclusion Low dose of NE can promote the blood pressure and renal perfusion in patients with septic shock.