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目的观察多巴胺、去甲肾上腺素对感染性休克患者动脉血乳酸及乳酸清除率的影响。方法将40例感染性休克患者随机分为A、B两组各20例,均进行充分液体复苏,A组给予多巴胺3-15μg.kg-1.min-1,B组给予去甲肾上腺素0.03-1.5μg.kg-1.min-1。比较用药后动脉血乳酸水平及乳酸清除率的变化。结果治疗后B组动脉血乳酸浓度明显低于A组(P<0.05),乳酸清除率显著高于A组(P<0.01),两组平均动脉压无明显差异(P>0.05)。结论去甲肾上腺素治疗感染性休克患者在降低动脉血乳酸水平、加快乳酸清除、改善组织缺血缺氧方面明显优于多巴胺。
Objective To observe the effects of dopamine and norepinephrine on lactic acid and lactic acid clearance in arterial blood of patients with septic shock. Methods Forty patients with septic shock were randomly divided into two groups (A and B): 20 patients received adequate liquid resuscitation, 3 to 15 μg.kg-1.min-1 for dopamine in group A, 0.03 to norepinephrine for group B -1.5 μg.kg-1.min-1. The arterial blood lactate levels and lactic acid clearance were compared after treatment. Results After treatment, the arterial blood lactic acid concentration of group B was significantly lower than that of group A (P <0.05), and the lactic acid clearance rate was significantly higher than that of group A (P <0.01). There was no significant difference between the two groups in mean arterial pressure (P> 0.05). Conclusion Noradrenaline is superior to dopamine in the treatment of septic shock in reducing arterial blood lactate level, accelerating lactic acid clearance, and improving tissue ischemia and hypoxia.