实用心脑肺血管病杂志
實用心腦肺血管病雜誌
실용심뇌폐혈관병잡지
PRACTICAL JOURNAL OF CARDIAC CEREBRAL PNEUMAL AND VASCULAR DISEASE
2015年
3期
25-28
,共4页
呼吸窘迫综合征,成人%呼吸,人工%呼出气冷凝液%过氧化氢%白介素6
呼吸窘迫綜閤徵,成人%呼吸,人工%呼齣氣冷凝液%過氧化氫%白介素6
호흡군박종합정,성인%호흡,인공%호출기냉응액%과양화경%백개소6
Respiratory distress syndrome,adult%Respiration,artificial%Exhaled breath condensate%Hydrogen peroxide%Interleukin 6
目的：探讨急性呼吸窘迫综合征（ARDS）机械通气患者呼出气冷凝液（EBC）中过氧化氢（H2O2）和白介素6（IL-6）水平变化及其临床意义。方法选取2012年9月—2013年12月贵阳医学院附属医院内科重症监护病房（ MICU）收治的ARDS患者42例，均经气管插管或气管切开进行机械通气治疗。按患者入住MICU两周后转归分为存活组22例和死亡组20例，比较两组患者机械通气后1、3、5、7 d急性生理学及慢性健康状况（ APACHE）Ⅱ评分、APACHEⅢ评分及 EBC 中 H2 O2、IL -6水平，分析两组患者机械通气后1、3、5、7 d APACHEⅡ评分、APACHE Ⅲ评分与EBC中H2 O2、IL-6水平的相关性。结果（1）存活组患者机械通气后3、5、7 d EBC中H2 O2和IL-6水平低于机械通气后1 d，死亡组患者机械通气后7 d EBC中H2 O2和IL-6水平高于机械通气后1、3、5 d（ P<0.05）。（2）机械通气后1 d两组患者APACHEⅡ和APACHEⅢ评分比较，差异无统计学意义（P>0.05）；机械通气后3、5、7 d死亡组患者APACHEⅡ和APACHE Ⅲ评分高于存活组（ P<0.05）。（3）械通气后1、3 d两组患者EBC中H2 O2和IL-6水平比较，差异无统计学意义（ P>0.05）；机械通气后5、7 d死亡组患者EBC中H2 O2和IL-6水平均高于存活组（P<0.05）。（4）存活组患者机械通气后不同时间点EBC中H2O2和IL-6水平与APACHEⅡ和APACHEⅢ评分间无直线相关关系（ P>0.05）；死亡组患者机械通气后5、7 d EBC中H2 O2水平与APACHEⅡ和APACHEⅢ评分呈正相关，EBC中IL-6水平与APACHEⅡ和APACHEⅢ评分呈负相关（ P<0.05）。结论 ARDS机械通气患者EBC中H2 O2和IL-6水平均升高，且与病情严重程度相关，其可作为气道炎性反应的监测指标，结合APACHE评分可为评估患者预后提供参考。
目的：探討急性呼吸窘迫綜閤徵（ARDS）機械通氣患者呼齣氣冷凝液（EBC）中過氧化氫（H2O2）和白介素6（IL-6）水平變化及其臨床意義。方法選取2012年9月—2013年12月貴暘醫學院附屬醫院內科重癥鑑護病房（ MICU）收治的ARDS患者42例，均經氣管插管或氣管切開進行機械通氣治療。按患者入住MICU兩週後轉歸分為存活組22例和死亡組20例，比較兩組患者機械通氣後1、3、5、7 d急性生理學及慢性健康狀況（ APACHE）Ⅱ評分、APACHEⅢ評分及 EBC 中 H2 O2、IL -6水平，分析兩組患者機械通氣後1、3、5、7 d APACHEⅡ評分、APACHE Ⅲ評分與EBC中H2 O2、IL-6水平的相關性。結果（1）存活組患者機械通氣後3、5、7 d EBC中H2 O2和IL-6水平低于機械通氣後1 d，死亡組患者機械通氣後7 d EBC中H2 O2和IL-6水平高于機械通氣後1、3、5 d（ P<0.05）。（2）機械通氣後1 d兩組患者APACHEⅡ和APACHEⅢ評分比較，差異無統計學意義（P>0.05）；機械通氣後3、5、7 d死亡組患者APACHEⅡ和APACHE Ⅲ評分高于存活組（ P<0.05）。（3）械通氣後1、3 d兩組患者EBC中H2 O2和IL-6水平比較，差異無統計學意義（ P>0.05）；機械通氣後5、7 d死亡組患者EBC中H2 O2和IL-6水平均高于存活組（P<0.05）。（4）存活組患者機械通氣後不同時間點EBC中H2O2和IL-6水平與APACHEⅡ和APACHEⅢ評分間無直線相關關繫（ P>0.05）；死亡組患者機械通氣後5、7 d EBC中H2 O2水平與APACHEⅡ和APACHEⅢ評分呈正相關，EBC中IL-6水平與APACHEⅡ和APACHEⅢ評分呈負相關（ P<0.05）。結論 ARDS機械通氣患者EBC中H2 O2和IL-6水平均升高，且與病情嚴重程度相關，其可作為氣道炎性反應的鑑測指標，結閤APACHE評分可為評估患者預後提供參攷。
목적：탐토급성호흡군박종합정（ARDS）궤계통기환자호출기냉응액（EBC）중과양화경（H2O2）화백개소6（IL-6）수평변화급기림상의의。방법선취2012년9월—2013년12월귀양의학원부속의원내과중증감호병방（ MICU）수치적ARDS환자42례，균경기관삽관혹기관절개진행궤계통기치료。안환자입주MICU량주후전귀분위존활조22례화사망조20례，비교량조환자궤계통기후1、3、5、7 d급성생이학급만성건강상황（ APACHE）Ⅱ평분、APACHEⅢ평분급 EBC 중 H2 O2、IL -6수평，분석량조환자궤계통기후1、3、5、7 d APACHEⅡ평분、APACHE Ⅲ평분여EBC중H2 O2、IL-6수평적상관성。결과（1）존활조환자궤계통기후3、5、7 d EBC중H2 O2화IL-6수평저우궤계통기후1 d，사망조환자궤계통기후7 d EBC중H2 O2화IL-6수평고우궤계통기후1、3、5 d（ P<0.05）。（2）궤계통기후1 d량조환자APACHEⅡ화APACHEⅢ평분비교，차이무통계학의의（P>0.05）；궤계통기후3、5、7 d사망조환자APACHEⅡ화APACHE Ⅲ평분고우존활조（ P<0.05）。（3）계통기후1、3 d량조환자EBC중H2 O2화IL-6수평비교，차이무통계학의의（ P>0.05）；궤계통기후5、7 d사망조환자EBC중H2 O2화IL-6수평균고우존활조（P<0.05）。（4）존활조환자궤계통기후불동시간점EBC중H2O2화IL-6수평여APACHEⅡ화APACHEⅢ평분간무직선상관관계（ P>0.05）；사망조환자궤계통기후5、7 d EBC중H2 O2수평여APACHEⅡ화APACHEⅢ평분정정상관，EBC중IL-6수평여APACHEⅡ화APACHEⅢ평분정부상관（ P<0.05）。결론 ARDS궤계통기환자EBC중H2 O2화IL-6수평균승고，차여병정엄중정도상관，기가작위기도염성반응적감측지표，결합APACHE평분가위평고환자예후제공삼고。
Objective To investigate the changes and clinical significances of hydrogen peroxide ( H2 O2 ) and interleukin-6 ( IL -6 ) levels in exhaled breath condensate ( EBC ) of patients with acute respiratory distress syndrome (ARDS)treated with mechanical ventilation. Methods From September 2012 to December 2013,a total of 42 patients with ARDS treated with mechanical ventilation were selected in MICU,the Second People′s Hospital of Guiyang,and they were divided into survival group ( n = 22 ) and death group ( n = 20 ) according to 2 - week prognosis after admission of MICU. APACHEⅡscore,APACHEⅢscore,H2 O2 and IL-6 levels in EBC were compared between the two groups after 1 day, 3 days,5 days,7 days of mechanical ventilation,and their correlations were analyzed. Results H2 O2 and IL-6 levels in EBC after 3 days,5 days,7 days of mechanical ventilation of survival group were lower than those after 1 day of mechanical ventilation,respectively;while H2 O2 and IL-6 level in EBC after 7 days of mechanical ventilation of death group were higher than those after 1 day,3 days,5 days of mechanical ventilation,respectively(P < 0.05). No statistically significant differences of APACHEⅡ score or APACHEⅢ score was found between the two groups after 1 day of mechanical ventilation( P>0. 05);while APACHEⅡscore and APACHEⅢscore of death group were higher than those of survival group after 3 days,5 days,7 days of mechanical ventilation,respectively(P<0. 05). No statistically significant differences of H2O2 or IL-6 level in EBC was found between the two groups after 1 day,3 days of mechanical ventilation,respectively(P>0. 05);while H2O2 and IL-6 levels in EBC of death group were higher than those of survival group after 5 days,7 days of mechanical ventilation, respectively(P<0. 05). In survival group,no linear correlation was found between H2O2 or IL-6 level in EBC at each time point and APACHEⅡscore or APACHEⅢscore(P>0. 05);in death group,H2O2 in EBC after 5 days,7 days of mechanical ventilation was positively correlated with APACHEⅡ score and APACHEⅢ score ,IL-6 level in EBC after 5 days,7 days of mechanical ventilation was negatively correlated with APACHEⅡscore and APACHEⅢscore(P<0. 05). Conclusion H2O2 and IL-6 levels in EBC of patients with ARDS treated with mechanical ventilation are higher and correlate with severity of illness,may be monitoring index of airway inflammatory reaction and provide evidences for predicting the prognosis by combining with APACHE score.
