摘要目的:分析小剂量多巴酚丁胺早期干预治疗肺炎合并脓毒症的效果。方法:回顾性分析台州市第一人民医院2015年1月至2018年1月收治的肺炎合并脓毒症患者200例的临床资料，依据治疗方法分为对照组、观察组各100例。对照组给予丙种球蛋白、甲泼尼龙及呼吸机辅助通气等治疗，观察组在对照组的基础上给予小剂量多巴酚丁胺治疗。比较两组临床疗效、肺功能、不良反应发生率、住院时间、呼吸困难消失时间、器官衰竭率及病死率。结果:观察组总有效率为96.0%（96/100），高于对照组的77.0%（77/100），差异有统计学意义（χ 2=15.45， P < 0.05）。治疗后，两组肺功能指标［用力肺活量（FVC）、第1秒用力呼气容积（FEV 1）及FEV 1/FVC］均改善，观察组均优于对照组，差异均有统计学意义（ t=-15.25、-34.56、-3.77，均 P < 0.001）。观察组住院时间、呼吸困难消失时间分别为（4.23±0.89）d、（3.21±0.58）d，均短于对照组的（8.96±1.58）d、（7.26±0.24）d，差异均有统计学意义（ t=-26.08、-64.52，均 P < 0.001）。观察组不良反应发生率、器官衰竭发生率、病死率分别为2.0%（2/100）、1.0%（1/100）、2.0%（2/100），均低于对照组的18.0%（18/100）、20.0%（20/100例）、10.0%（10/100），差异均有统计学意义（χ 2=16.80、19.20、5.67，均 P < 0.05）。 结论:小剂量多巴酚丁胺早期干预治疗肺炎合并脓毒症，可显著提高临床疗效，减少不良反应，降低器官衰竭发生率及病死率，改善肺功能，缩短住院时间、呼吸困难消失时间。

abstractsObjective:To investigate the effects of early intervention with low-dose dobutamine on pneumonia complicated with sepsis.Methods:We retrospectively analyzed the clinical data of 200 patients with pneumonia complicated by sepsis who received treatment in the First People's Hospital of Taizhou from January 2015 to January 2018. We divided these patients into control and observation groups with 100 patients/group according to different treatment methods. The control group was treated with immunoglobulin and methylprednisolone and given ventilator-assisted ventilation. The observation group was given low-dose dobutamine based on the treatments given in the control group. Clinical efficacy, pulmonary function, the incidence of adverse reactions, length of hospital stay, time to dyspnea disappearance, organ failure rate, and mortality were compared between the two groups.Results:Total response rate was significantly higher in the observation group than in the control group [96.0% (96/100) vs. 77.0% (77/100), χ2 = 15.45, P < 0.05]. After treatment, improvements in the pulmonary function indexes [forced vital capacity, forced expiratory volume in one second, and forced expiratory volume in one second/forced vital capacity] in the observation group were superior compared with those in the control group ( t = -15.25, -34.56, -3.77, all P < 0.001). Length of hospital stay and time to dyspnea disappearance in the observation group were (4.23 ± 0.89) days and (3.21 ± 0.58) days, respectively, which were significantly shorter than those in the control group [(8.96 ± 1.58) days, (7.26 ± 0.24) days, t = -26.08, -64.52, both P < 0.001]. The incidence of adverse reactions, incidence of organ failure, and mortality in the observation group were 2.0% (2/100), 1.0% (1/100) and 2.0% (2/100) respectively, which were significantly lower than those in the control group [18.0% (18/100), 20.0% (20/100), 10.0% (10/100), χ2 = 16.80, 19.20, 5.67, all P < 0.05). Conclusion:Early intervention with low-dose dobutamine for the treatment of pneumonia complicated by sepsis can greatly improve clinical efficacy, reduce adverse reactions, decrease the incidence of organ failure and mortality, improve pulmonary function, and shorten the length of hospital stay and time to dyspnea disappearance.