Comparison of the effects of different doses of norepinephrine on hemodynamics,NF - κB and IκB - α in patients with septic shock / 中国基层医药

ABSTRACT

Objective To investigate the effect of high dose norepinephrine on hemodynamics, nuclear transcription factor κB (NF - κB) and human nuclear factor kappa B inhibitor protein alpha(IκB - α) in patients with septic shock. Methods From January 2016 to January 2017,50 patients with septic shock in Taizhou Central Hospital were selected and randomly divided into two groups according to the digital table,with 25 cases in each group. The control group was given small dose(1 - 30μg/ min) norepinephrine,and the study group was given large dose(2 - 50μg/ min) norepinephrine. The hemodynamics,expression of NF - κB and IκB - α before and after treat-ment were compared between the two groups. Results Before treatment,there were no statistically significant differ-ences in heart and hemodynamics between the two groups[control group heart rate (116. 5 ± 11. 8)beats/ min,MAP (47. 2 ± 6. 4) mmHg,CVP(3. 6 ± 0. 5) mmHg;study group heart rate (115. 3 ± 12. 1) beats/ min,MAP(46. 9 ± 6. 8mmHg),CVP(5. 1 ± 1. 6)mmHg,t = 1. 529,1. 036,1. 229,P = 0. 861,0. 102,0. 935]. After treatment,the heart rate of the study group[(86. 5 ± 9. 8) beats/ min] was significantly lower than that of the control group[(99. 4 ± 10. 5)beats/ min](t = 11. 852,P = 0. 031),and CVP[(82. 3 ± 6. 9)mmHg],MAP[(5. 9 ± 1. 8)mmHg]of the study group were significantly higher than those of the control group[(75. 1 ± 5. 9) mmHg,(5. 1 ± 1. 6) mmHg] ( t =12. 943,13. 058,P = 0. 038,0. 019). The renal function of the two groups had no statistically significant differences before treatment (t = 1. 382,1. 951,P = 0. 061,0. 075). After treatment,the Cr and BUN of the study group were significantly higher than those of the control group( t = 16. 082,15. 943,P = 0. 021,0. 023). The expression of NF - κB and IκB - α of the two groups had no statistically significant differences before treatment (t = 1. 482,1. 503, P = 0. 081,0. 092). After treatment,the expression of NF - κB and IκB - α of the study group were significantly lower than those of the control group ( t = 10. 639,11. 835, all P < 0. 05). Conclusion The effect of high - dose norepinephrine in the treatment of patients with septic shock is ideal,which is beneficial to improve the physiological indicators and NF - κB,IκB - α.