多巴胺联合美托洛尔治疗小儿肺炎伴心力衰竭的临床效果及对心肌酶水平的影响研究

摘要

ObjectiveTo study the clinical effect of dopamine combined with metoprolol in the treatment of infantile pneumonia with heart failure and its effect on the level of myocardial enzyme.Method214 children with pneumonia and heart failure treated in our hospital from February 2011 to February 2014 were selected and divided into research group and control group, 107 cases in each group. Children in both groups were given routine medical treatment, research group children were given dopamine combined with metoprolol additionally. The clinical effects, changes in vital signs before and after treatment, improvement time of symptoms and signs, the changes of myocardial enzyme levels and adverse reactions before and after treatment were compared between the two groups.ResultThe total effective rate of research group was signiifcantly higher than control group (P<0.05). There were no signiifcant differences in heart rate, respiration and blood oxygen saturation between the two groups before reatment (P>0.05); the index were signiifcantly improved after treatment, research group was signiifcantly better than control group (P<0.05). The improvement time of heart rate, respiratory rate, pulmonary rales and irritability symptom in research group were signiifcantly shorter than control group (P<0.05). There were no signiifcant differences in the levels of lactate dehydrogenase and creatine kinase before treatment between the two groups (P>0.05), and both groups were signiifcantly improved after treatment, research group was signiifcantly better than control group (P<0.05). There were no signiifcant adverse reactions in both groups.ConclusionThe application of dopamine combined with metoprolol in the treatment of infantile pneumonia with heart failure can signiifcantly promote the efifcacy, improve the childrens' svital signs, accelerate the relief of symptoms and reverse the state of heart failure with good safety, worthy to be popularized in the clinical practice.%目的：研究多巴胺联合美托洛尔治疗小儿肺炎伴心力衰竭的临床效果及对心肌酶水平的影响。方法选取本院2011年2月至2014年2月收治的214例小儿肺炎伴心力衰竭患儿为研究对象，按照随机数表法将其分为研究组和对照组，每组各107例。两组患儿均给予常规内科治疗，研究组患儿在对照组治疗基础上加用多巴胺联合美托洛尔治疗。对比两组患儿临床疗效、治疗前后生命体征变化情况、症状体征改善时间、治疗前后心肌酶水平变化及不良反应发生情况。结果研究组患儿治疗总有效率显著优于对照组（P＜0.05）。两组患儿治疗前心率、呼吸、血氧饱和度比较均无显著差异（P＞0.05）；治疗后均较治疗前显著改善，研究组改善幅度显著优于对照组（P＜0.05）。研究组患儿心率加快、呼吸加速、肺部啰音、烦躁的改善时间均显著短于对照组（P＜0.05）。两组患儿治疗前乳酸脱氢酶及肌酸激酶同工酶水平比较均无明显差异（P＞0.05）；治疗后上述指标均较治疗前显著改善，研究组改善幅度显著优于对照组（P＜0.05）。两组患儿均无明显不良反应发生。结论多巴胺联合美托洛尔治疗小儿肺炎伴心力衰竭，可显著提升疗效，改善患儿生命体征，逆转心力衰竭状态，且安全性好，值得临床推广应用。