甲泼尼龙琥珀酸钠对呼吸窘迫综合征患者肺功能及炎症状况的影响
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摘要
目的探讨甲泼尼龙琥珀酸钠对呼吸窘迫综合征患者肺功能及炎症状况的影响。方法通过数字随机方法将90例呼吸窘迫综合征患者分成对照组与观察组各45例,对照组采用常规治疗,观察组则在常规治疗的同时采用甲泼尼龙琥珀酸钠治疗,观察比较2组患者的肺功能及炎症状况。结果治疗后,观察组的Murray急性肺损伤评分、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)评分均显著低于对照组(P <0. 05);治疗后,2组的肺总量(TLC)、肺活量(VC)、用力呼气肺活量(FVC)各项肺功能指标水平均较治疗前显著提高(P <0. 05),且观察组各项肺功能指标水平显著高于对照组(P <0. 05);与治疗前相比,2组治疗后的白细胞介素-6(IL-6)、白细胞介素-8 (IL-8)、肿瘤坏死因子-α(TNF-α)各项炎症因子水平均显著降低(P <0. 05),且观察组各项炎症因子水平均显著低于对照组(P <0. 05); 2组的不良反应发生率差异无统计学意义(P> 0. 05)。结论采用甲泼尼龙琥珀酸钠治疗呼吸窘迫综合征患者能取得较为理想的疗效,可显著改善患者肺功能,降低炎症水平,且安全性高。
Objective To analyze the effect of methylprednisolone sodium succinate on pulmonary function and inflammation in patients with respiratory distress syndrome. Methods A total of90 patients with respiratory distress syndrome were randomly divided into two groups,with 45 per group. The control group received routine treatment,while the observation group was given methylprednisolone sodium succinate at the same time of routine treatment. The pulmonary function and inflammation were observed and compared between the two groups. Results After treatment,the Murray acute lung injury score,Acute Physiology and Chronic Health Score II(APACHE II) of the observation group were significantly lower than those of the control group(P < 0. 05). Compared with before treatment,the total lung capacity(TLC),vital capacity(VC),forced expiratory vital capacity(FVC) and other lung function indicators in the observation group were significantly improved after treatment(P < 0. 05),and the lung function indicators above in the observation group after treatment were significantly higher than those in the control group(P < 0. 05). Compared with before treatment,the levels of interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α) and other inflammatory factors in the two groups were significantly lower after treatment(P < 0. 05),and the levels of inflammatory factors in the observation group were significantly lower than those in the control group(P < 0. 05). There was no significant difference in the incidence of adverse reactions between the two groups(P > 0. 05). Conclusion Methylprednisolone sodium succinate in the treatment of respiratory distress syndrome patients can achieve a better curative effect,significantly improve lung function,and reduce the level of inflammation,and has high safety.
Objective To analyze the effect of methylprednisolone sodium succinate on pulmonary function and inflammation in patients with respiratory distress syndrome. Methods A total of90 patients with respiratory distress syndrome were randomly divided into two groups,with 45 per group. The control group received routine treatment,while the observation group was given methylprednisolone sodium succinate at the same time of routine treatment. The pulmonary function and inflammation were observed and compared between the two groups. Results After treatment,the Murray acute lung injury score,Acute Physiology and Chronic Health Score II(APACHE II) of the observation group were significantly lower than those of the control group(P < 0. 05). Compared with before treatment,the total lung capacity(TLC),vital capacity(VC),forced expiratory vital capacity(FVC) and other lung function indicators in the observation group were significantly improved after treatment(P < 0. 05),and the lung function indicators above in the observation group after treatment were significantly higher than those in the control group(P < 0. 05). Compared with before treatment,the levels of interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α) and other inflammatory factors in the two groups were significantly lower after treatment(P < 0. 05),and the levels of inflammatory factors in the observation group were significantly lower than those in the control group(P < 0. 05). There was no significant difference in the incidence of adverse reactions between the two groups(P > 0. 05). Conclusion Methylprednisolone sodium succinate in the treatment of respiratory distress syndrome patients can achieve a better curative effect,significantly improve lung function,and reduce the level of inflammation,and has high safety.
引文
[1]张若旸,詹庆元.糖皮质激素在急性呼吸窘迫综合征治疗和预防中的研究进展[J].内科急危重症杂志,2018,24(5):353-355,358.
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[6]凌洪.持续血液净化联合糖皮质激素治疗重症胰腺炎并发呼吸窘迫综合征的临床效果研究[J].中国现代普通外科进展,2017,20(6):444-446,450.
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[9]王彦,邓英,郭嫒博.糖皮质激素在重症社区获得性肺炎致急性呼吸窘迫综合征综合救治中的价值探讨[J].内蒙古医学杂志,2016,48(9):1106-1107.
[10]许红阳,王大鹏,臧芝栋,等.应激剂量糖皮质激素在ARDS治疗中的应用效果[J].江苏医药,2016,42(16):1786-1788
[11]张靖雯,陈复辉.糖皮质激素在急性呼吸窘迫综合征患者中的应用[J].实用药物与临床,2016,19(7):916-919.
[12]李英,齐见旭.短程低剂量甲泼尼龙抑制ARDS炎症因子及其作用机制研究[J].海南医学,2016,27(5):722-724.
[13]王碧炯,丁群力,张巧丽,等.654-2联合甲泼尼龙治疗老年急性呼吸窘迫综合征患者的效果[J].中国老年学杂志,2016,36(4):877-878.
[14]刘双敬,李立维,王伟,等.糖皮质激素在创伤致ARDS患者救治中的临床价值[J].临床肺科杂志,2013,18(7):1260-1261.
[15]李淑英,李继荣,齐国艳.糖皮质激素治疗急性呼吸窘迫综合征的疗效观察[J].中国医药指南,2015,13(33):113-114.
[16]周明.糖皮质激素在重症社区获得性肺炎致急性呼吸窘迫综合征综合救治中的应用价值[J].临床医学工程,2015,22(1):57-58.
[17]许红阳,姜淑云,臧芝栋,等.糖皮质激素对早期ARDS患者的治疗效果[J].江苏医药,2014,40(21):2618-2619.
[18]赵文飚,万晟霞,顾德芳,等.糖皮质激素雾化吸入对呼吸窘迫综合征患者肺纤维化的疗效观察[J].解放军医学杂志,2014,39(9):741-745.
[19]赵淑清,赵艳荣.小剂量注射用甲泼尼龙琥珀酸钠冲击治疗对儿童难治性支原体肺炎的效果[J].医学综述,2017,23(4):798-801.
[20]王晋忠.甲泼尼龙琥珀酸钠不同方案对老年慢性阻塞性肺疾病急性加重期患者疗效及安全性比较[J].中国基层医药,2018,25(10):1318-1322.
[2]刘树理,潘景业.大肠杆菌致急性呼吸窘迫综合征患者应用糖皮质激素治疗的效果及对患者IL-8、IL-6水平的影响[J].数理医药学杂志,2018,31(7):1040-1041.
[3]王海军,邢学忠,高勇,等.糖皮质激素对急性呼吸窘迫综合征近期预后的影响[J].医学研究杂志,2018,47(2):112-114,111.
[4]张延.应激剂量糖皮质激素在ARDS治疗中的应用效果分析[J].当代临床医刊,2017,30(6):3507-3507.
[5]史家欣,李家树,李小美,等.低剂量长疗程糖皮质激素治疗急性呼吸窘迫综合征的效果及安全性研究[J].实用医学杂志,2017,33(18):3092-3095.
[6]凌洪.持续血液净化联合糖皮质激素治疗重症胰腺炎并发呼吸窘迫综合征的临床效果研究[J].中国现代普通外科进展,2017,20(6):444-446,450.
[7]吴晓文,李军,尧国胜,等.早期糖皮质激素治疗急性呼吸窘迫综合征临床疗效研究[J].现代医药卫生,2017,33(4):562-564.
[8]肖永久,汪建新.系统性糖皮质激素在呼吸危重症治疗中的获益与风险[J].中国呼吸与危重监护杂志,2016,15(6):619-624.
[9]王彦,邓英,郭嫒博.糖皮质激素在重症社区获得性肺炎致急性呼吸窘迫综合征综合救治中的价值探讨[J].内蒙古医学杂志,2016,48(9):1106-1107.
[10]许红阳,王大鹏,臧芝栋,等.应激剂量糖皮质激素在ARDS治疗中的应用效果[J].江苏医药,2016,42(16):1786-1788
[11]张靖雯,陈复辉.糖皮质激素在急性呼吸窘迫综合征患者中的应用[J].实用药物与临床,2016,19(7):916-919.
[12]李英,齐见旭.短程低剂量甲泼尼龙抑制ARDS炎症因子及其作用机制研究[J].海南医学,2016,27(5):722-724.
[13]王碧炯,丁群力,张巧丽,等.654-2联合甲泼尼龙治疗老年急性呼吸窘迫综合征患者的效果[J].中国老年学杂志,2016,36(4):877-878.
[14]刘双敬,李立维,王伟,等.糖皮质激素在创伤致ARDS患者救治中的临床价值[J].临床肺科杂志,2013,18(7):1260-1261.
[15]李淑英,李继荣,齐国艳.糖皮质激素治疗急性呼吸窘迫综合征的疗效观察[J].中国医药指南,2015,13(33):113-114.
[16]周明.糖皮质激素在重症社区获得性肺炎致急性呼吸窘迫综合征综合救治中的应用价值[J].临床医学工程,2015,22(1):57-58.
[17]许红阳,姜淑云,臧芝栋,等.糖皮质激素对早期ARDS患者的治疗效果[J].江苏医药,2014,40(21):2618-2619.
[18]赵文飚,万晟霞,顾德芳,等.糖皮质激素雾化吸入对呼吸窘迫综合征患者肺纤维化的疗效观察[J].解放军医学杂志,2014,39(9):741-745.
[19]赵淑清,赵艳荣.小剂量注射用甲泼尼龙琥珀酸钠冲击治疗对儿童难治性支原体肺炎的效果[J].医学综述,2017,23(4):798-801.
[20]王晋忠.甲泼尼龙琥珀酸钠不同方案对老年慢性阻塞性肺疾病急性加重期患者疗效及安全性比较[J].中国基层医药,2018,25(10):1318-1322.