目的 探讨去甲肾上腺素联合多巴胺在感染中毒性休克液体复苏中的作用。方法 采用回顾性研究方法，选择2015年2月—2018年1月在榆林市星元医院ICU诊治的144例感染中毒性休克患者作为研究对象，根据治疗方法的不同分为观察组74例与对照组70例。两组都给予充分液体复苏，对照组给予多巴胺辅助治疗，观察组给予去甲肾上腺素联合多巴胺辅助治疗，记录两组6 h复苏率与28 d死亡率，记录两组治疗前与治疗3 d后的心率（HR）、混合静脉血氧饱和度（SvO₂）、尿量、内生肌酐清除率及白介素-4（IL-4）、白介素-10（IL-10）。结果 观察组的6 h复苏率与28 d死亡率分别为70.3%和24.3%，对照组分别为47.1%和47.1%，两组比较差异具有统计学意义（P<0.05）。两组治疗后的SvO₂都显著高于治疗前，且观察组高于对照组，差异均有统计学意义（P<0.05）；观察组治疗后的HR低于治疗前，也低于对照组，差异均有统计学意义（P<0.05）。治疗后，两组的尿量与内生肌酐清除率都显著高于治疗前，同组治疗前后比较差异有统计学意义（P<0.05）；且观察组高于对照组，差异有统计学意义（P<0.05）。治疗后，两组血清IL-4和IL-10水平都显著低于治疗前，同组治疗前后比较差异有统计学意义（P<0.05）；且观察组低于对照组，差异有统计学意义（P<0.05）。结论 去甲肾上腺素联合多巴胺在感染中毒性休克液体复苏中的应用能抑制炎症因子的释放，改善患者的肾功能与血气指标，从而提高复苏率与降低死亡率。

Objective To investigate the effects of norepinephrine combined with dopamine on fluid resuscitation in septic shock. Methods Retrospective study method was adopted, patients (144 cases) with septic shock in Xingyuan Hospital of Yulin from February 2015 to January 2018 were selected and were divided into observation group (74 cases) and control group (70 cases) according to the different treatment methods. The two groups were given full fluid resuscitation, the control group received dopamine-assisted therapy, and the observation group received norepinephrine combined with dopamine-assisted therapy. Resuscitation rate at 6 h and mortality rate at 28 d were recorded in the two groups, as well as HR, SvO₂, urine volume, endogenous creatinine scavenging rate, IL-4 and IL-10 before and after treatment were recorded in the two groups. Results The 6 h recovery rate and 28 d mortality rate in the observation group were 70.3% and 24.3%, respectively, and the control group were 47.1% and 47.1%, respectively, and compard the difference were statistically significantly (P<0.05). After treatment, the SvO₂ in two groups were significantly higher than that before the treatment, and the observation group were higher than control group (P<0.05), the HR in the observation group were lower than that before the treatment, and were lower than the control group, compared the difference were statistically significantly (P<0.05). After treatment, the urine volume and the endogenous creatinine clearance rate were significantly higher than those before treatment (P<0.05), and the observation group were higher than the control group, and compared the difference was statistically significantly (P<0.05). After treatment, the levels of serum IL-4 and IL-10 in two groups were significantly lower than that before the treatment (P<0.05), and the observation group were lower than the control group (P<0.05). Conclusion The application of norepinephrine combined with dopamine in the fluid resuscitation of toxic shock can inhibit the release of inflammatory factors, improve the renal function and blood gas index of patients, so as to improve the resuscitation rate and reduce the mortality.