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多巴胺对急性重症胰腺炎合并感染性休克患者肾功能的影响
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【关键词】 多巴胺；胰腺炎,急性坏死性；休克,脓毒性；肾脏功能
Effect of dopamine on renal function in the patients with acute severe pancreatitis complicated with septic shock
【Abstract】 AIM: To study the effect of dopamine on the renal function in the patients with acute severe pancreatitis complicated with septic shock. METHODS: Thirtynine patients with acute severe pancreatitis complicated with septic shock were divided into 3 groups according to the maximal infusing rate of dopamine used: group A, n=14, 2-9 μg/(kg・min); group B, n=14, 10-15 μg/(kg・min); and group C, n=11, >15 μg/(kg・min). Mean arterial blood pressure(MAP), heart rate(HR), urine output, blood urea nitrogen(BUN), creatinine(CRE), urine albumin(UALB) and urine β2microglubulin (Uβ2MG) as well as APACHE III scores were detected and recorded for all the patients. RESULTS: Before antishock therapy, hypotension, tachycardia and oliguria occurred to all 39 patients with acute severe pancreatitis complicated with septic shock, and CRE, BUN, UALB, Uβ2MG and APACHE III scores were above the normal in most cases. After antishock therapy, MAP, HR, urine output and BUN, CRE in all patients from the 3 groups gradually returned to their normal levels(P<0.05 vs those before antishock therapy), and UALB, Uβ2MG output and APACHE III scores also restored but still remained in their abnormal levels (P<0.01 vs those before antishock therapy). CONCLUSION: The first goal to treat the patients with acute severe pancreatitis complicated with septic shock should be the restoration of the organ blood supply, and based on volume resuscitation. Dopamine and other vasoactive drugs could be adjunctively used to maintain circulatory stability.
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