中国临床药理学与治疗学2025，Vol.30Issue(9)：1200-1207,8.DOI:10.12092/j.issn.1009-2501.2025.09.006
间羟胺与去甲肾上腺素对高原脓毒性休克患者舌下微循环的影响及疗效的比较
A comparative analysis of the effects of metaraminol and norepi-nephrine on sublingual microcirculation in patients experiencing sep-tic shock at high altitudes
摘要
Abstract
AIM:To compare the effects and effi-cacy of methoxyamine and norepinephrine on sub-lingual microcirculation in patients with high-alti-tude septic shock.METHODS:A total of forty-six patients with septic shock from the Xining area of Qinghai Province were randomized into two groups:the M-hydroxylamine group(Group M,n=22)and the norepinephrine group(Group N,n=24).Baseline data as well as the incidence of acute kid-ney injury(AKI),distal limb necrosis/ischemia,and 28-day survival rates were documented.Sublingual microcirculation parameters were monitored and recorded at four time points:before treatment(T0),24 hours post-treatment(T1),48 hours post-treatment(T2),and 72 hours post-treatment(T3)using side-flow dark-field(SDF)imaging.The pa-rameters included total vascular density(TVD),per-fused vascular density(PVD),perfused vessel ratio(PPV),microvascular flow index(MFI),and hetero-geneity index(HI).Additionally,changes in heart rate(HR),mean arterial pressure(MAP),blood urea nitrogen(BUN),serum creatinine(Cr),and lac-tate(Lac)levels were also recorded.RESULTS:There were no significant differences between the two groups in terms of baseline data,incidence of AKI,distal limb necrosis/ischemia,and 28-day sur-vival rate.Additionally,there were no significant differences in HR,MAP,and Lac indices between the two groups at any time point.However,within-group comparisons showed that HR,MAP,and Lac indices improved over the course of treatment,with statistically significant differences.The BUN level at the T3 time point was significantly lower in the mehydroxyamine group compared to the nor-epinephrine group(P<0.05).Similarly,Cr levels were significantly lower at both T2 and T3 time points(P<0.05).There were no significant differenc-es in sublingual microcirculation indices between the two groups at any time point.However,TVD,PVD,PPV,MIF,and HI in both groups improved over the course of treatment,with statistically sig-nificant differences.CONCLUSION:Both methoxy-amine and norepinephrine can enhance both the macrocirculation and sublingual microcirculation in patients with septic shock at high altitudes.Addi-tionally,methoxyamine leads to a faster recovery of creatinine levels within 72 hours.关键词
间羟胺/去甲肾上腺素/舌下微循环/高原/脓毒性休克Key words
metaraminol/norepinephrine/sublin-gual microcirculation/high altitudes/septic shock分类
医药卫生引用本文复制引用
何宗钊,王皓,郑兴,孙斌,邓莉..间羟胺与去甲肾上腺素对高原脓毒性休克患者舌下微循环的影响及疗效的比较[J].中国临床药理学与治疗学,2025,30(9):1200-1207,8.基金项目
青海省卫生计生系统指导性计划课题(2020-wjzdx-03) （2020-wjzdx-03）
2023年度青海省"昆仑英才·高层次卫生健康人才"项目 （）
