2024 年第 8 期 第 0 卷

氢溴酸山莨菪碱联合多巴胺对感染性休克的临床疗效观察

Clinical efficacy of anisodamine hydrobromide combined with dopamine in the treatment of septic shock

作者：侯琛琛1王钰2王玉芹3

英文作者：Hou Chenchen1 Wang Yu2 Wang Yuqin3

单位：1青岛大学附属青岛市市立医院急症科，青岛266071；2青岛大学附属青岛市市立医院内科，青岛266071；3青岛大学附属青岛市市立医院急诊室，青岛266071

英文单位：1Department of Emergency Medicine Qingdao Municipal Hospital Affiliated to Qingdao University Qingdao 266071 China; 2Department of Internal Medicine Qingdao Municipal Hospital Affiliated to Qingdao University Qingdao 266071 China; 3Emergency Room Qingdao Municipal Hospital Affiliated to Qingdao University Qingdao 266071 China

关键词：感染性休克；氢溴酸山莨菪碱；多巴胺

英文关键词：Septicshock;Anisodaminehydrobromide;Dopamine

• 摘要：

• 目的 探讨氢溴酸山莨菪碱联合多巴胺对感染性休克的临床疗效。方法 采用随机单盲对照研究方法。选取2020年6月至2023年6月青岛大学附属青岛市市立医院收治的感染性休克患者102例。应用随机数字表法分为对照组和观察组，各51例。对照组在常规治疗的基础上给予多巴胺静脉注射治疗；观察组在对照组的基础上给予氢溴酸山莨菪碱静脉注射治疗，2组均治疗12 h后观察。比较2组的临床疗效及治疗前后的尿量、收缩压、心率、氧摄取率、氧供指数、氧耗指数及血清心肌肌钙蛋白I（cTnI）、B型脑钠肽（BNP）、肿瘤坏死因子α（TNF-α）、降钙素原及白细胞介素1（IL-1）水平。结果 经过治疗，观察组总有效率高于对照组［88.2%（45/51）比70.6%（36/51）］，差异有统计学意义（χ2=4.857，P=0.028）。治疗后，观察组的尿量、收缩压、氧摄取率、氧供指数及氧耗指数均大于/高于对照组，心率及血清cTnI、BNP、TNF-α、降钙素原、IL-1水平均低于对照组，差异均有统计学意义（均P<0.05）。结论 应用氢溴酸山莨菪碱与多巴胺联合治疗感染性休克，临床效果较为理想，有助于增加患者的尿量、升高血压、改善心功能和组织氧代谢指标，促进生命体征稳定，降低炎症反应。

• Objective To investigate the clinical efficacy of anisodamine hydrobromide combined with dopamine in the treatment of septic shock. Methods  The randomized single-blind controlled study was conducted. A total of 102 patients with septic shock admitted to Qingdao Municipal Hospital Affiliated to Qingdao University from June 2020 to June 2023 were selected. According to the random number table method, they were divided into control group and observation group, with 51 cases in each group. The control group was treated with intravenous dopamine on the basis of conventional treatment. The observation group was treated with intravenous injection of anisodamine hydrobromide on the basis of the control group, and the two groups were observed after 12 h of treatment. The clinical efficacy, urine volume, systolic blood pressure, heart rate, oxygen extraction rate, oxygen supply index, oxygen consumption index, and serum cardiac troponin I (cTnI), B-type natriuretic peptide (BNP), tumor necrosis factor-α (TNF-α), procalcitonin and interleukin-1 (IL-1) levels before and after treatment were compared between the two groups. Results  After treatment, the total effective rate of the observation group was higher than that of the control group［88.2%(45/51) vs 70.6%(36/51)］（χ2=4.857, P=0.028). After treatment, the urine volume, systolic blood pressure, oxygen extraction rate, oxygen delivery index and oxygen consumption index of the observation group were higher than those of the control group, and the heart rate and serum levels of cTnI, BNP, TNF-α, procalcitonin, IL-1 were lower than those of the control group(all P<0.05). Conclusion  The clinical effect of anisodamine hydrobromide combined with dopamine in the treatment of septic shock is ideal, which is helpful to increase the urine volume of patients, increase blood pressure, improve cardiac function and tissue oxygen metabolism indexes, promote the stability of vital signs, and reduce inflammatory response.