{"title":"在脓毒性休克患者的治疗中,去甲肾上腺素在降低死亡风险和血流动力学方面优于多巴胺","authors":"Xudong Lu, Xianghua Xu, Yue-e Wu","doi":"10.1515/pteridines-2021-0002","DOIUrl":null,"url":null,"abstract":"Abstract Background To investigate the clinical effects of norepinephrine versus dopamine in treatment of septic shock by pooling the data form open published clinical trials. Material and Methods The clinical trials relevant to norepinephrine versus dopamine in treatment of septic shock were electronically searched in the databases of Pubmed, Embase, the Cochrane Library, Web of Science, Google scholar and CNKI. The original data related to the treatment effects such as death risk, oxygen metabolism and hemodynamics index were extracted from the included original studies. The death risk was pooled by the effect size of relative risk (RR), the oxygen metabolism and hemodynamics index were pooled by standard mean difference (SMD) and the corresponding 95% confidence interval (95%CI). The publication bias was evaluated by Begg's funnel plot and Egger's line regression test. Results Thirteen clinical trials were included in the meta-analysis. The pooled results demonstrated the death risk was significantly decreased (RR=0.89, 95%CI:0.81 to 0.98, p=0.024) in septic shock patients who received norepinephrine compared to those receiving dopamine. The HR (SMD=−1.84, 95%CI: −2.86 to −0.81, p<0.01) and cardiac index (SMD=−0.74, 95%CI: −1.01 to −0.48, p<0.01) were lower in norepinephrine group compared to dopamine group. The systemic vascular resistance index (SMD=1.33, 95%CI:0.62 to 2.04, p<0.01) in norepinephrine group was higher than those of dopamine group with statistical difference. The Begg's funnel plot and Egger's line regression test (t=−0.84, p=0.425) showed no publication bias. Conclusions Based on the present evidence, norepinephrine was superior to dopamine in the aspects of death risk reducing and hemodynamics.","PeriodicalId":20792,"journal":{"name":"Pteridines","volume":"32 1","pages":"5 - 10"},"PeriodicalIF":0.5000,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/pteridines-2021-0002","citationCount":"0","resultStr":"{\"title\":\"Norepinephrine was superior in death risk reducing and hemodynamics compared to dopamine in treatment of patients with septic shock\",\"authors\":\"Xudong Lu, Xianghua Xu, Yue-e Wu\",\"doi\":\"10.1515/pteridines-2021-0002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Abstract Background To investigate the clinical effects of norepinephrine versus dopamine in treatment of septic shock by pooling the data form open published clinical trials. Material and Methods The clinical trials relevant to norepinephrine versus dopamine in treatment of septic shock were electronically searched in the databases of Pubmed, Embase, the Cochrane Library, Web of Science, Google scholar and CNKI. The original data related to the treatment effects such as death risk, oxygen metabolism and hemodynamics index were extracted from the included original studies. The death risk was pooled by the effect size of relative risk (RR), the oxygen metabolism and hemodynamics index were pooled by standard mean difference (SMD) and the corresponding 95% confidence interval (95%CI). The publication bias was evaluated by Begg's funnel plot and Egger's line regression test. Results Thirteen clinical trials were included in the meta-analysis. The pooled results demonstrated the death risk was significantly decreased (RR=0.89, 95%CI:0.81 to 0.98, p=0.024) in septic shock patients who received norepinephrine compared to those receiving dopamine. The HR (SMD=−1.84, 95%CI: −2.86 to −0.81, p<0.01) and cardiac index (SMD=−0.74, 95%CI: −1.01 to −0.48, p<0.01) were lower in norepinephrine group compared to dopamine group. The systemic vascular resistance index (SMD=1.33, 95%CI:0.62 to 2.04, p<0.01) in norepinephrine group was higher than those of dopamine group with statistical difference. The Begg's funnel plot and Egger's line regression test (t=−0.84, p=0.425) showed no publication bias. Conclusions Based on the present evidence, norepinephrine was superior to dopamine in the aspects of death risk reducing and hemodynamics.\",\"PeriodicalId\":20792,\"journal\":{\"name\":\"Pteridines\",\"volume\":\"32 1\",\"pages\":\"5 - 10\"},\"PeriodicalIF\":0.5000,\"publicationDate\":\"2021-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1515/pteridines-2021-0002\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pteridines\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1515/pteridines-2021-0002\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"BIOCHEMISTRY & MOLECULAR BIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pteridines","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1515/pteridines-2021-0002","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"BIOCHEMISTRY & MOLECULAR BIOLOGY","Score":null,"Total":0}
Norepinephrine was superior in death risk reducing and hemodynamics compared to dopamine in treatment of patients with septic shock
Abstract Background To investigate the clinical effects of norepinephrine versus dopamine in treatment of septic shock by pooling the data form open published clinical trials. Material and Methods The clinical trials relevant to norepinephrine versus dopamine in treatment of septic shock were electronically searched in the databases of Pubmed, Embase, the Cochrane Library, Web of Science, Google scholar and CNKI. The original data related to the treatment effects such as death risk, oxygen metabolism and hemodynamics index were extracted from the included original studies. The death risk was pooled by the effect size of relative risk (RR), the oxygen metabolism and hemodynamics index were pooled by standard mean difference (SMD) and the corresponding 95% confidence interval (95%CI). The publication bias was evaluated by Begg's funnel plot and Egger's line regression test. Results Thirteen clinical trials were included in the meta-analysis. The pooled results demonstrated the death risk was significantly decreased (RR=0.89, 95%CI:0.81 to 0.98, p=0.024) in septic shock patients who received norepinephrine compared to those receiving dopamine. The HR (SMD=−1.84, 95%CI: −2.86 to −0.81, p<0.01) and cardiac index (SMD=−0.74, 95%CI: −1.01 to −0.48, p<0.01) were lower in norepinephrine group compared to dopamine group. The systemic vascular resistance index (SMD=1.33, 95%CI:0.62 to 2.04, p<0.01) in norepinephrine group was higher than those of dopamine group with statistical difference. The Begg's funnel plot and Egger's line regression test (t=−0.84, p=0.425) showed no publication bias. Conclusions Based on the present evidence, norepinephrine was superior to dopamine in the aspects of death risk reducing and hemodynamics.
期刊介绍:
Pteridines is an open acess international quarterly journal dealing with all aspects of pteridine research. Pteridines are heterocyclic fused ring compounds involved in a wide range of biological functions from the color on butterfly wings to cofactors in enzyme catalysis to essential vitamins. Of the pteridines, 5,6,7,8-tetrahydrobiopterin is the necessary cofactor of several aromatic amino acid monoxygenases, the nitric oxide synthases and glyceryl ether monoxygenase (GEMO). Neopterin plays an essential role in the immune system and is an important biomarker in laboratory medicine for diseases such as HIV, cardiovascular disease, malignant tumors, among others.
Topics:
-Neopterin, dihydroneopterin, monapterin-
Biopterin, tetrahydrobiopterin-
Folates, antifolates, riboflavin-
Phenylalanine, tyrosine, phenylketonuria, serotonin, adrenalin, noradrenalin, L-DOPA, dopamine, related biogenic amines-
Phenylalanine hydroxylase, tyrosine hydroxylase, tryptophan hydroxylase, nitric oxide synthases (iNOS), alkylglycerol monooxygenase (AGMO), dihydropterin reductase, sepiapterin reductase-
Homocysteine, mediators of inflammation, redox systems, iron.