李江林,卢小虎,谢刚
LI Jiang-lin,LU Xiao-hu,XIE Gang(The 2nd Clinical Medicine College of Jinan University

• 1:暨南大学第二临床医学院深圳市人民医院龙华分院

摘要(Abstract)：

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(APACHEⅢ)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。
Objective To observe the effect of low-dose norepinephrine(NE) on the renal perfusion in patients with septic shock.Methods A total of 74 patients with septic shock were treated with the highest infusing rate of NE at 0.01~0.1 μg/(kg·min).NE was infused by micro pump trough central vein start at 0.01 μg/(kg·min),and then its dosage was adjusted according to patients' blood pressure,until the mean arterial pressure reach 75 mmHg.All the tested patients 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.

关键词(KeyWords)： 去甲肾上腺素;感染性休克;肾脏血流灌注
norepinephrine;septic shock;renal perfusion

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 李江林,卢小虎,谢刚
LI Jiang-lin,LU Xiao-hu,XIE Gang(The 2nd Clinical Medicine College of Jinan University

参考文献(References)：

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