中国中西医结合急救杂志
中國中西醫結閤急救雜誌
중국중서의결합급구잡지
INTEGRATED TRADITIONAL CHINESE AND WESTERN MEDICINE IN PRACTICE OF CRITICAL CARE MEDICINE
2014年
2期
88-90
,共3页
梁欢%王军%苗常青%南佳彦%彭波
樑歡%王軍%苗常青%南佳彥%彭波
량환%왕군%묘상청%남가언%팽파
休克,脓毒性%氢化可的松琥珀酸钠
休剋,膿毒性%氫化可的鬆琥珀痠鈉
휴극,농독성%경화가적송호박산납
Septic shock%Hydrocortisone sodium succinate
目的：探讨氢化可的松琥珀酸钠对脓毒性休克患者疗效及预后的影响。方法采用前瞻性研究方法，将2010年1月至2012年1月西安交通大学医学院第一附属医院急诊科收治的49例脓毒性休克患者，按入院顺序的奇偶数分为治疗组24例与对照组25例。两组均给予常规治疗，治疗组在常规治疗基础上加用氢化可的松琥珀酸钠200 mg，每日1次，连用5 d。观察治疗前及治疗后24 h、72 h、7 d两组血清降钙素原（PCT）和C-反应蛋白（CRP）水平；并比较两组14 d病死率。结果治疗前及治疗后24 h，两组PCT、CRP比较差异均无统计学意义（均P＞0.05），治疗后72 h、7 d两组PCT和CRP水平均较治疗前明显下降，以7 d下降最显著；且治疗组较对照组下降更明显〔PCT（μg/L）：治疗后72 h 9.73±2.10比12.36±2.56，治疗后7 d 5.33±2.05比8.76±1.78；CRP（μg/L）：治疗后72 h 69.12±13.61比109.68±16.16，治疗后7 d 20.16±9.64比42.32±13.16，均P＜0.05〕。但对照组和治疗组患者14 d病死率比较差异无统计学意义（52.0%比45.8%，P＞0.05）。结论氢化可的松琥珀酸钠能减轻脓毒性休克患者的炎症反应，对改善病情有一定临床价值。
目的：探討氫化可的鬆琥珀痠鈉對膿毒性休剋患者療效及預後的影響。方法採用前瞻性研究方法，將2010年1月至2012年1月西安交通大學醫學院第一附屬醫院急診科收治的49例膿毒性休剋患者，按入院順序的奇偶數分為治療組24例與對照組25例。兩組均給予常規治療，治療組在常規治療基礎上加用氫化可的鬆琥珀痠鈉200 mg，每日1次，連用5 d。觀察治療前及治療後24 h、72 h、7 d兩組血清降鈣素原（PCT）和C-反應蛋白（CRP）水平；併比較兩組14 d病死率。結果治療前及治療後24 h，兩組PCT、CRP比較差異均無統計學意義（均P＞0.05），治療後72 h、7 d兩組PCT和CRP水平均較治療前明顯下降，以7 d下降最顯著；且治療組較對照組下降更明顯〔PCT（μg/L）：治療後72 h 9.73±2.10比12.36±2.56，治療後7 d 5.33±2.05比8.76±1.78；CRP（μg/L）：治療後72 h 69.12±13.61比109.68±16.16，治療後7 d 20.16±9.64比42.32±13.16，均P＜0.05〕。但對照組和治療組患者14 d病死率比較差異無統計學意義（52.0%比45.8%，P＞0.05）。結論氫化可的鬆琥珀痠鈉能減輕膿毒性休剋患者的炎癥反應，對改善病情有一定臨床價值。
목적：탐토경화가적송호박산납대농독성휴극환자료효급예후적영향。방법채용전첨성연구방법，장2010년1월지2012년1월서안교통대학의학원제일부속의원급진과수치적49례농독성휴극환자，안입원순서적기우수분위치료조24례여대조조25례。량조균급여상규치료，치료조재상규치료기출상가용경화가적송호박산납200 mg，매일1차，련용5 d。관찰치료전급치료후24 h、72 h、7 d량조혈청강개소원（PCT）화C-반응단백（CRP）수평；병비교량조14 d병사솔。결과치료전급치료후24 h，량조PCT、CRP비교차이균무통계학의의（균P＞0.05），치료후72 h、7 d량조PCT화CRP수평균교치료전명현하강，이7 d하강최현저；차치료조교대조조하강경명현〔PCT（μg/L）：치료후72 h 9.73±2.10비12.36±2.56，치료후7 d 5.33±2.05비8.76±1.78；CRP（μg/L）：치료후72 h 69.12±13.61비109.68±16.16，치료후7 d 20.16±9.64비42.32±13.16，균P＜0.05〕。단대조조화치료조환자14 d병사솔비교차이무통계학의의（52.0%비45.8%，P＞0.05）。결론경화가적송호박산납능감경농독성휴극환자적염증반응，대개선병정유일정림상개치。
Objective To investigate the clinical efficacy of hydrocortisone sodium succinate for treatment of septic shock patients and their prognoses. Methods A prospective case control study was conducted. 49 patients with septic shock in the Department of Emergency of the First Affiliated Hospital of Xi'an Jiaotong University were enrolled from January 2010 to January 2012,and the patients were sequentially divided into two groups,the treatment group(24 cases)and the control group(25 cases),by the difference in odd or even number. All patients in the two groups accepted the conventional treatment. The treatment group additionally received hydrocortisone sodium succinate injection 200 mg,once a day for 5 days. The levels of serum procalcitonin(PCT),C-reactive protein(CRP)were measured in all the patients before treatment and 24 hours,72 hours and 7 days after treatment. The mortalities were compared in 14 days between the two groups. Results The levels of PCT,CRP before and 24 hours after treatment were not statistically significant different from those of pre-treatment in two groups(all P>0.05). PCT and CRP were decreased at 72 hours and 7 days after treatment in the two groups,and on the 7th day the decline was more significant, and compared with the control group,the levels of PCT and CRP in treatment group were reduced more markedly at 72 hours and on the 7th day〔PCT(μg/L):72 hours 9.73±2.10 vs. 12.36±2.56,7 days 5.33±2.05 vs. 8.76±1.78;CRP(μg/L):72 hours 69.12±13.61 vs. 109.68±16.16,7 days 20.16±9.64 vs. 42.32±13.16,all P<0.05〕. But the mortality in 14 days was not statistically significant different between control group and treatment group(52.0%vs. 45.8%,P>0.05). Conclusion The treatment with hydrocortisone sodium succinate can reduce the inflammation of patients with septic shock,thus it has clinical value in the improvement of the disease situation.
