中国临床药理学杂志2017，Vol.33Issue(15)：1387-1390,4.DOI:10.13699/j.cnki.1001-6821.2017.15.001
右美托咪定治疗重症脓毒血症合并急性肺损伤和肾损伤患者的临床研究
Clinical trial of dexmedetomidine in the treatment of severe sepsis patients with acute lung and kidney injury
摘要
Abstract
Objective To observe the influences of dexmedetomidine (DEX) on efficacy,inflammatory factors,liver and kidney functions in severe sepsis patients with acute lung and kidney injury.Methods A total of 60 severe sepsis patients with acute lung and kidney injury were randomly divided into treatment group and control group,30 cases in each group.Patients in two groups were maintained with regular treatment.Patients in treatment group were received DEX injection 1 μg · kg-1 · h-1 for early sedative treatment.While,patients in control group were received propofol injection for early sedative treatment.They were treated for 48 h.Time of mechanical ventilation,intensive care unit (ICU) stay time,and duration of continuous renal replacement therapy (CRRT) were recorded.Liver and kidney functions indexes and the levels of inflammatory factors in two groups before and after treatment were detected.Results ICU stay time and duration of CRRT in control group were (96.32 ± 13.51),(61.30 ±9.85)h,had significant difference with those in treatment group,which were (76.18 ± 11.32),(52.93 ± 9.21) h (P ＜ 0.01).After operation,the levels of procalcitonin,C reactive protein,interleukin-6 and tumor necrosis factor in treatment group were(2.05 ±0.39),(56.36 ±9.94),(78.72 ± 11.33),(17.56 ±4.07)ng · L-1,had significant differences with those in eontrol group,which were (2.43 ±0.24),(79.91 ± 12.55),(92.07 ± 12.55),(24.41 ±4.25) ng · L-1 (all P ＜ 0.01).After operation,the levels of alanine aminotransferase,aspartate transaminase,alkaline phosphatase,total bilirubin,blood urea nitrogen and serum creatinine in treatment group were (21.37 ± 4.73) U·L-1,(29.61 ±6.97)g · L-1,(67.27 ±7.26)U · L-1,(11.36 ±2.91)μmol · L-1,(7.03 ±2.03) mmol· L-1,(87.98 ±10.56)μmol · L-1,had significant difference with those in control group,which were (30.46±6.44)U· L-1,(38.60 ±7.53)g · L-1,(71.75 ±8.41)U · L-1,(14.72 ±2.29)μmol · L-1,(10.07 ± 3.12) mmol · L-1,(123.73 ± 11.74) μmol · L-1 (all P ＜ 0.05).There was no significant adverse drug reaction in two groups.Conclusion Compared with propofol,dexmedetomidine has better clinical effect for severe sepsis patients with acute lung injury by improving the inflammatory factors and protecting organ.关键词
重症脓毒血症/急性肺损伤/右美托咪定/炎症因子/肝肾功能Key words
severe sepsis/acute lung and kidney injury/dexmedetomidine/inflammatory factor/liver and kidney function分类
医药卫生引用本文复制引用
曾燕萍,马卫星,缪志军,向辉,薛骅,丁峰,柳东之,钱振华..右美托咪定治疗重症脓毒血症合并急性肺损伤和肾损伤患者的临床研究[J].中国临床药理学杂志,2017,33(15):1387-1390,4.基金项目
浙江省医学会临床科研基金资助项目(2015ZYC-A84) （2015ZYC-A84）
