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目的探究多巴酚丁胺对新生儿肺动脉高压患儿C-反应蛋白(CRP)、脑钠肽(BNP)及D-二聚体(D-D)水平的影响。方法收集义乌市妇幼保健计划生育服务中心儿科收治的新生儿肺动脉高压患儿72例,根据治疗方法不同分为对照组和观察组,观察组36例,对照组36例,两组患儿均给予常规治疗,对照组患儿给予高通气治疗,动脉血氧分压(PaO_2)维持在>80 mm Hg,二氧化碳分压(PaCO_2)为30~35 mm Hg;观察组患儿在对照组治疗的基础上给予盐酸多巴酚丁胺注射液5μg·kg~(-1)·min~(-1)静脉持续泵入,两组患儿治疗时间均为48 h。治疗结束后对比分析两组患儿CRP、BNP、D-D、血气分析以及不良反应情况。结果治疗后两组患儿CRP、BNP、D-D水平降低(P<0.05);与对照组相比,观察组患儿CRP、BNP及D-D水平较低(P<0.05),两组患儿PaO_2、血氧饱和度(SpO_2)水平升高(P<0.05),肺动脉高压水平降低(P<0.05);与对照组相比,观察组PaO_2、SpO_2较高(P<0.05),肺动脉高压水平较低(P<0.05),两组患儿不良反应相比差异无统计学意义(P>0.05)。结论多巴酚丁胺治疗新生儿肺动脉高压能够下调CRP、BNP及D-D水平,抑制炎症反应以及早期心肌损伤,改善高凝状态,安全性较高。
Objective To investigate the effects of dobutamine on the levels of C-reactive protein, BNP and D-D in neonates with pulmonary hypertension. Methods 72 cases of neonatal pulmonary hypertension were collected from pediatric family planning service center of Yiwu Maternal and Child Health Care Center and divided into control group and observation group according to different treatment methods. 36 cases in observation group and 36 cases in control group were given The patients in the control group were given hyperventilation. PaO_2 was maintained at> 80 mm Hg and PaCO_2 was 30-35 mm Hg. The basis of treatment in the control group The rats were treated with 5μg · kg -1 min -1 intravenous infusion of dobutamine hydrochloride injection for 48 hours. After treatment, the CRP, BNP, D-D, blood gas analysis and adverse reactions in two groups were compared and analyzed. Results The levels of CRP, BNP and DD in the two groups were decreased after treatment (P <0.05). Compared with the control group, the levels of CRP, BNP and DD in the observation group were lower (P <0.05) Compared with the control group, the PaO_2 and SpO_2 in the observation group were higher (P <0.05) and the levels of pulmonary hypertension were lower in the observation group (P <0.05) (P <0.05). There was no significant difference in adverse reactions between the two groups (P> 0.05). Conclusions Dobutamine treatment of neonatal pulmonary hypertension can down-regulate the levels of CRP, BNP and D-D, inhibit inflammatory reaction and early myocardial injury, improve hypercoagulability and have higher safety.