极早期应用去甲肾上腺素对脓毒症休克患者NLR、CAR的影响OA

Objective:To investigate the effects of very early Norepinephrine on neutrophil to lymphocyte ratio(NLR)and C reactive protein to albumin ratio(CAR)in patients with septic shock.Method:A total of 60 patients with septic shock admitted to Department of Critical Care Medicine,Jiujiang University Affiliated Hospital from January 2022 to December 2023 were selected and divided into early group(n=30)and conventional group(n=30)according to random number table method.In the early group,Norepinephrine(0.3 mg/kg)was given by intravenous micropumping at the same time during liquid resuscitation,and in the conventional group,the same dose of Norepinephrine was given by intravenous micropumping immediately after liquid resuscitation reached the standard,and mean arterial pressure≥65 mmHg was maintained in both groups.Peripheral venous blood was collected at admission and 1 and 3 days after treatment to assess NLR and CAR in both groups.Arterial blood was taken at admission and 1,3,6,12 h after treatment to assess blood lactate(Lac)levels in both groups.Acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)scores were recorded in both groups before and 3 days after treatment.Result:After 1 and 3 days of treatment,NLR and CAR in the early group were significantly lower than those in the conventional group,the differences were statistically significant(P<0.001).After 1,3,6 and 12 h of treatment,Lac levels in early group were lower than those in conventional group,the differences were statistically significant(P<0.05).After 3 days of treatment,APACHEⅡ score of early group was significantly lower than that of conventional group,the difference was statistically significant(P<0.05).Conclusion:For septic shock patients,very early use of Norepinephrine can better reduce the inflammatory response of patients and improve clinical prognosis.