中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2010年
19期
21-24
,共4页
黄昭%王思荣%陈裕胜%刘继云
黃昭%王思榮%陳裕勝%劉繼雲
황소%왕사영%진유성%류계운
呼吸窘迫综合征,成人%低温%细胞因子类
呼吸窘迫綜閤徵,成人%低溫%細胞因子類
호흡군박종합정,성인%저온%세포인자류
Respiratory distress syndrome,adult%Hypothermia%Cytokines
目的 探讨亚低温治疗对急性呼吸窘迫综合征(ARDS)患者血清炎性介质水平、肺功能保护及临床预后的影响.方法 本研究为对照性研究,选取56例1997-2007年住院的ARDS患者按入院时查分组表进行随机分组.其中29例接受常规治疗加亚低温治疗(治疗组),27例仅接受常规治疗(对照组).所有患者均于治疗前及治疗后3、7 d时抽血检测血浆肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及C反应蛋白(CRP)水平,同时记录患者氧合指数、SOFA评分及肺损伤性评分,比较28 d内两组患者生存率等临床指标,并详细记录各种不良反应.结果 治疗组TNF-α、IL-6及CRP水平均显著低于对照组,同时氧合指数、SOFA评分及肺损伤性评分亦较对照组明显改善(P<0.05);且28 d内治疗组生存率高于对照组[65.5%(19/29)比51.9%(14/27)],而机械通气时间[(11.9±3.6)d比(17.0±5.1)d]、ICU住院时问[(14.1±4.2)d比(21.5±7.7)d]明显缩短(P<0.05).结论 亚低温治疗能显著缓解ARDS患者机体炎性反应,有效改善肺部氧合及短期预后.
目的 探討亞低溫治療對急性呼吸窘迫綜閤徵(ARDS)患者血清炎性介質水平、肺功能保護及臨床預後的影響.方法 本研究為對照性研究,選取56例1997-2007年住院的ARDS患者按入院時查分組錶進行隨機分組.其中29例接受常規治療加亞低溫治療(治療組),27例僅接受常規治療(對照組).所有患者均于治療前及治療後3、7 d時抽血檢測血漿腫瘤壞死因子-α(TNF-α)、白細胞介素-6(IL-6)及C反應蛋白(CRP)水平,同時記錄患者氧閤指數、SOFA評分及肺損傷性評分,比較28 d內兩組患者生存率等臨床指標,併詳細記錄各種不良反應.結果 治療組TNF-α、IL-6及CRP水平均顯著低于對照組,同時氧閤指數、SOFA評分及肺損傷性評分亦較對照組明顯改善(P<0.05);且28 d內治療組生存率高于對照組[65.5%(19/29)比51.9%(14/27)],而機械通氣時間[(11.9±3.6)d比(17.0±5.1)d]、ICU住院時問[(14.1±4.2)d比(21.5±7.7)d]明顯縮短(P<0.05).結論 亞低溫治療能顯著緩解ARDS患者機體炎性反應,有效改善肺部氧閤及短期預後.
목적 탐토아저온치료대급성호흡군박종합정(ARDS)환자혈청염성개질수평、폐공능보호급림상예후적영향.방법 본연구위대조성연구,선취56례1997-2007년주원적ARDS환자안입원시사분조표진행수궤분조.기중29례접수상규치료가아저온치료(치료조),27례부접수상규치료(대조조).소유환자균우치료전급치료후3、7 d시추혈검측혈장종류배사인자-α(TNF-α)、백세포개소-6(IL-6)급C반응단백(CRP)수평,동시기록환자양합지수、SOFA평분급폐손상성평분,비교28 d내량조환자생존솔등림상지표,병상세기록각충불량반응.결과 치료조TNF-α、IL-6급CRP수평균현저저우대조조,동시양합지수、SOFA평분급폐손상성평분역교대조조명현개선(P<0.05);차28 d내치료조생존솔고우대조조[65.5%(19/29)비51.9%(14/27)],이궤계통기시간[(11.9±3.6)d비(17.0±5.1)d]、ICU주원시문[(14.1±4.2)d비(21.5±7.7)d]명현축단(P<0.05).결론 아저온치료능현저완해ARDS환자궤체염성반응,유효개선폐부양합급단기예후.
Objective To explore the effect of mild hypothermia on inflammation status,lung function protection and clinical prognosis in patients with acute respiratory distress syndrome (ARDS).Methods All of 56 patients with ARDS were randomly divided into two groups: trial group (29 patients,treatment with mild hypothermia) and control group (27 patients, treatment with common practice). The following parameters including tumor necrosis factor (TNF)-α,interleukin (IL)-6 and C reactive protein (CRP), oxygenation index, SOFA evaluation and injury of lungs evaluation were detemined before treatment and at the 3rd, 7th day after treatment, and survival rates and adverse reaction in 28 days also were observed.Results After treatment, the levels of TNF-α ,IL-6 and CRP were decreased significantly, and oxygenation index, the scores of SOFA evaluation and injury of lungs evaluation were improved significantly in trial group than those in control group (P<0.05 ). The survival rate in trial group was higher than that in control group after treatment of 28 days [65.5%(19/29) vs 51.9%(14/27)]. The courses of mechanical ventilation and staying in ICU in trial group were shorter than those in control group [(11.9±3.6)d vs (17.0±5.1)d,(14.1±4.2)d vs (21.5±7.7)d](P<0.05). Conclusion Mild hypothermia can effectively attenuate inflammation disorder, improve damaged lung function and prognosis in patients with ARDS.
