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目的探讨不同剂量多巴胺联合多巴酚丁胺对重症肺炎患儿血清C反应蛋白(CRP)、免疫球蛋白水平的影响。方法选取2010年3月—2016年9月肇庆市第一人民医院收治的重症肺炎患儿52例,采用随机数字表法分为对照组和观察组,每组26例。在常规治疗基础上,对照组患儿采用常规剂量多巴胺联合多巴酚丁胺治疗,观察组患儿采用小剂量多巴胺联合多巴酚丁胺治疗;两组患儿均持续治疗5 d。比较两组患儿治疗前后白细胞计数(WBC)、血清CRP及免疫球蛋白水平,临床疗效,不良反应发生率。结果两组患儿治疗前WBC、血清CRP水平比较,差异无统计学意义(P>0.05);观察组患儿治疗后WBC、血清CRP水平低于对照组(P<0.05)。两组患儿治疗前血清IgG、IgA、IgM水平比较,差异无统计学意义(P>0.05);观察组患儿治疗后血清IgG、IgA、IgM水平高于对照组(P<0.05)。观察组患儿临床疗效优于对照组(P<0.05)。观察组患儿不良反应发生率低于对照组(P<0.05)。结论与常规剂量多巴胺联合多巴酚丁胺相比,小剂量多巴胺联合多巴酚丁胺可更有效地降低重症肺炎患儿血清CRP水平,升高血清免疫球蛋白水平,且安全性较高。
Objective To investigate the effects of different dosages of dopamine and dobutamine on serum C-reactive protein (CRP) and immunoglobulin levels in children with severe pneumonia. Methods From March 2010 to September 2016, 52 cases of severe pneumonia admitted to the First People’s Hospital of Zhaoqing City were divided into control group and observation group by random number table, with 26 cases in each group. On the basis of routine treatment, the control group of children with conventional dose of dopamine and dobutamine treatment, the observation group of children with low-dose dopamine and dobutamine treatment; two children were treated for 5 days. The WBC, serum CRP and immunoglobulin levels, clinical efficacy and incidence of adverse reactions in both groups were compared before and after treatment. Results There was no significant difference in WBC and serum CRP levels between the two groups before treatment (P> 0.05). The WBC and serum CRP levels in the treatment group were lower than those in the control group (P <0.05). The levels of serum IgG, IgA and IgM in two groups before treatment were not significantly different (P> 0.05). The levels of IgG, IgA and IgM in serum of the observation group were higher than those of the control group after treatment (P <0.05). The clinical efficacy of the observation group was better than that of the control group (P <0.05). The incidence of adverse reactions in observation group was lower than that in control group (P <0.05). Conclusions Compared with conventional dose of dopamine and dobutamine, low dose of dopamine combined with dobutamine can reduce serum CRP level and serum immunoglobulin level in children with severe pneumonia more effectively and with higher safety.