本文關(guān)鍵詞：右美托咪定治療重癥膿毒血癥合并急性肺損傷和腎損傷患者的臨床研究　出處：《中國臨床藥理學(xué)雜志》2017年15期 　論文類型：期刊論文

  更多相關(guān)文章： 重癥膿毒血癥 急性肺損傷 右美托咪定 炎癥因子 肝腎功能

【摘要】：目的觀察右美托咪定對重癥膿毒血癥合并急性肺損傷和腎損傷患者的臨床療效、炎癥因子及肝腎損傷的影響。方法將60例重癥膿毒血癥合并急性肺損傷和腎損傷患者隨機(jī)分為對照組30例和試驗組30例。2組患者均維持常規(guī)治療。對照組使用丙泊酚注射液進(jìn)行早期鎮(zhèn)靜治療;試驗組給予右美托咪定注射液1μg·kg~(-1)·h~(-1)進(jìn)行早期鎮(zhèn)靜治療。2組患者治療時間均為48 h。記錄2組患者機(jī)械通氣時間、重癥監(jiān)護(hù)病房(ICU)入住時間及腎替代治療(CRRT)持續(xù)時間。檢測2組治療前后的血清炎癥因子水平及肝腎功能指標(biāo)。結(jié)果對照組的ICU入住時間和CRRT持續(xù)時間分別為(96.32±13.51),(61.30±9.85)h;試驗組分別為(76.18±11.32),(52.93±9.21)h(P0.01)。治療后,試驗組和對照組的降鈣素原分別為(2.05±0.39),(2.43±0.24)ng·L~(-1);C-反應(yīng)蛋白分別為(56.36±9.94),(79.91±12.55)ng·L~(-1);白細(xì)胞介素-6分別為(78.72±11.33),(92.07±12.55)ng·L~(-1);腫瘤壞死因子-α分別為(17.56±4.07),(24.41±4.25)ng·L~(-1),差異均有統(tǒng)計學(xué)意義(均P0.01)。治療后,試驗組和對照組的谷丙轉(zhuǎn)氨酶分別為(21.37±4.73),(30.46±6.44)U·L~(-1);谷草轉(zhuǎn)氨酶分別為(29.61±6.97),(38.60±7.53)g·L~(-1);堿性磷酸分別為(67.27±7.26),(71.75±8.41)U·L~(-1);總膽紅素分別為(11.36±2.91),(14.72±2.29)μmol·L~(-1);尿素氮分別為(7.03±2.03),(10.07±3.12)mmol·L~(-1);血清肌酸酐分別為(87.98±10.56),(123.73±11.74)μmol·L~(-1),差異均有統(tǒng)計學(xué)意義(均P0.05)。2組患者治療過程中均未出現(xiàn)明顯的藥物不良反應(yīng)。結(jié)論與丙泊酚相比,右美托咪定對癥膿毒血癥合并急性肺損傷和腎損傷患者有更好的臨床療效,對臟器的保護(hù)作用及炎癥因子的改善作用更強。
[Abstract]:Objective To observe the clinical effect of dexmedetomidine combined with acute lung injury and acute kidney injury in patients with severe sepsis, inflammatory factors and liver injury. Methods 60 cases of severe sepsis complicated with acute lung injury and renal injury patients were randomly divided into control group of 30 cases and 30 cases of test group patients in group.2 were maintained in conventional treatment the control group using Propofol Injection early sedative treatment; the experimental group was given dexmedetomidine injection 1 g - kg~ (-1) - h~ (-1) for early.2 sedation groups of patients treated for 48 h. records of 2 patients with mechanical ventilation and ICU stay time (ICU) and renal replacement the duration of treatment (CRRT). The serum levels of inflammatory factors and liver function indexes before and after treatment in 2 groups. The control group of ICU in time and duration of CRRT were (96.32 + 13.51), (61.30 + 9.85) H; experimental group respectively. 涓，

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