Objective To analyze the effects of different doses of dobutamine and dopamine on serum levels of inflammatory factors and immune factors in children with severe pneumonia.Methods Eighty-two children with severe pneumonia from November 2014 to March 2016 were selected.According to the different doses of dopamine, they were divided into control group (n=41) and study group (n=41).Both groups were treated by regular treatment measures, on this basis, the control group was treated with conventional dose of dopamine and dobutamine, the study group was used dobutamine with small dose of dopamine, both groups were treated for 5 days.We had statistics of clinical efficacy, the incidence of adverse reactions of the two groups, the serum inflammatory factors of interleukin-6 (IL-6), interleukin-8 (IL-8), C-reactive protein (CRP), tumor necrosis factor-α(TNF-α), nuclear factor [TLR2, immune level transcription factor (NF-κB), myeloid differentiation factor 88 (MyD88)] level were compared between the two groups before and after treatment.Results The total effective rate of the study group (95.12%) was higher than that of the control group (85.37%), but the difference was not statistically significant (P>0.05).Before treatment, there was no significant difference in the levels of IL-6, IL-8, CRP, TNF-α, TLR2, NF-κB or MyD88 between the two groups (P>0.05);after treatment, the levels of IL-6, IL-8, CRP, TNF-α, TLR2, NF-κB and MyD88 in study group were better than those in the control group, the differences were statistically significant (P<0.05).The incidence rate of adverse reactions in the study group (4.88%) was significantly lower than that in the control group (21.96%), and the difference was statistically significant (P<0.05).Conclusions The curative effect of dobutamine combined with small dose of dopamine in the treatment of children with severe pneumonia is effective, can effectively improve the level of serum inflammatory factors and immune factors, improve the therapeutic effect, reduce the incidence of adverse reactions, has the value of popularization.%目的 分析多巴酚丁胺联合不同剂量多巴胺对重症肺炎患儿血清炎症因子水平、免疫因子水平的影响.方法 选取2014年11月至2016年3月82例重症肺炎患儿,根据多巴胺用药剂量不同分为对照组(n=41)和研究组(n=41).两组均于入院后给予常规治疗措施,在此基础上对照组联合采用多巴酚丁胺与常规剂量多巴胺,研究组联合采用多巴酚丁胺与小剂量多巴胺,两组均持续治疗5 d.统计两组临床疗效、不良反应发生率,对比治疗前后两组血清炎症因子[白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]水平、免疫因子[TLR2、核转录因子(NF-κB)、髓样分化因子88(MyD88)]水平变化情况.结果 研究组总有效率(95.12%)与对照组(85.37%)比较差异未见统计学意义(P>0.05).治疗前两组IL-6、IL-8、CRP、TNF-α、TLR2、NF-κB、MyD88水平比较差异未见统计学意义(P>0.05);治疗后研究组IL-6、IL-8、CRP、TNF-α、TLR2、NF-κB、MyD88优于对照组,差异有统计学意义(P<0.05).研究组不良反应发生率(4.88%)明显低于对照组(21.96%),差异有统计学意义(P<0.05).结论 联合采用多巴酚丁胺与小剂量多巴胺治疗重症肺炎患儿疗效确切,可有效改善其血清炎症因子及免疫因子水平,提高治疗效果,降低不良反应发生率,具有推广价值.
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