Effect of Shenfu injection on blood lactate and inflammatory factors in patients with severe infectious shock / 中国基层医药

ABSTRACT

Objective To investigate the effects of dopamine combined with norepinephrine on blood lactate and inflammatory factors in elderly patients with severe septic shock. Methods 116 patients with severe septic shock were randomly divided into control group and observation group according to the random number table method , 58 cases in each group. The control group was given the basic treatment of western medicine,the observation group was given Shenfu injection on the basis of the treatment of the control group. The patients were treated for 7 days. The heart rate ( HR) ,mean arterial pressure ( MAP) ,central venous pressure ( CVP) ,blood lactate ( Lac) ,urine output, acute physiology and chronic health score ( APACHEⅡ) were observed before and after treatment. The tumor necrosis factor ( TNF- α) , interleukin -6 ( IL -6 ) and C - reactive protein ( CRP ) were measured before and after treatment. The changes of inflammatory cytokines were observed before and after treatment. The 28-day mortality and average length of hospital stay were observed. Results After treatment,the HR of the control group was not improved compared with before treatment[(121. 32 ± 11. 85)beats/min vs. (123. 65 ± 14. 05)beats/min,t=1. 66,P=0. 98]. The HR of the observation group decreased, and there was significant difference compared with before treatment [(96. 55 ± 10. 65) beats/min vs. (123. 60 ± 13. 98) beats/min,t=11. 84,P=0. 00]. The MAP and CVP of the two groups were higher than before treatment,and there were significant differences compared with before treatment ( all P<0. 05). The urine volume of the two groups was higher than before treatment,and that of the observation group was higher than the control group (t=20. 40,P=0. 00). The score of APACHEⅡ,TNF-α,IL-6 and CRP of the two groups were lower than before treatment,which of the observation group were lower than those of the control group ( all P<0. 05). The difference of 28-day mortality rate between the two groups was not statistically significant(13. 79%vs. 22. 41%,χ2 =1. 45,P=0. 23). The average hospital stay of the observation group was shorter than that in the control group [(23. 39 ± 5. 81)d vs. (28. 76 ± 6. 23)d,t=6. 52,P=0. 00]. Conclusion Dopamine combined with norepinephrine can improve the vital signs of patients with severe septic shock,reduce the concentration of lactate in blood,improve the level of inflammatory factors and heart index.