摘要
目的研究不同剂量甲泼尼龙(MP)对急性肺损伤(ALI)早期血管内皮生长因子(VEGF)的影响,为临床治疗提供理论依据。方法选择2005年3月至2008年12月温州医学院附属育英儿童医院收治的符合ALI诊断标准的儿童重症监护病房(PICU)患儿48例,随机分为3组:ALI组11例,HALI组(大剂量MP干预)22例,LALI组(小剂量MP干预)15例,正常对照组(NC)8例。应用ELISA法检测入院0、24、48、72h血清VEGF,采用美国NOVA生化血气分析仪检测血气分析,日本血乳酸测定仪(便携式)检测血乳酸。结果 (1)ALI组、HALI组、LALI组各时间血清VEGF、血乳酸高于NC组,氧合指数(PaO2/FiO2)低于NC组,差异均有统计学意义(P<0.05);(2)24、48、72h时HALI组、LALI组血清VEGF、血乳酸低于ALI组,高于ALI组,差异均有统计学意义(P<0.05);(3)24、48、72hHALI组与LALI组血清VEGF、血乳酸及PaO2/FiO2差异均无统计学意义(P>O.05);(4)72h内HALI组、LALI组发展为急性呼吸窘迫综合征(ARDS)病例百分率少于ALI组,差异有统计学意义(P<0.05),HALI组与LALI组发展为ARDS病例百分率差异无统计学意义(P>O.05)。结论 ALI早期VEGF表达增加,小剂量MP通过抑制血清VEGF表达,从而抑制ALI病情进展。
Objective To explore the effects of methylprednisolone （MP） of different doses on vascular endothelial growth factor （VEGF） of early acute lung injury （ALl）, providing a theoretical basis for clinical treatment. Methods Totally 48 cases who met ALI diagnostic criteria from PICU were randomly divided into 3 groups ： group ALI, group HALI （treated by high-dose MP）, group LALI （treated by low-dose MP）. Eight heathy individuals were selected as control group （NC）. Results （1）As compared with group NC, the serum VEGF and blood lactate were significantly higher, while oxygenation index was significantly lower than in other groups （P 〈0.05）. （2）Contents of serum VEGF, blood lac- tate of group HALl and LALI stepped significantly down, but oxygenation index stepped significantly up than group ALl after 24 h （P 〈 0.05） ; （3）Between group HALl and LALI, the serum VEGF, blood lactate,oxygenation index at 24 h, 48 h and 72 h had no significant differences （P 〉 0.05）. （4）Compared with group ALL, ARDS（acute respiratory distress syndrome） patients within 72h were stepped up significantly than group HALl and LALI （P 〈 0.05）, but there were no significant differences between the two groups （P 〉 0.05）. Conclusion The expression of VEGF is increased in early ALl ; low-dose MP can inhibit the progression of ALI by inhibiting the expression of serum VEGF.
出处
《中国实用儿科杂志》
CSCD
北大核心
2010年第10期791-793,共3页
Chinese Journal of Practical Pediatrics
关键词
急性肺损伤
急性呼吸窘迫综合征
甲泼尼龙
血管内皮生长因子
acute lung injury
acute respiratory distress syndrome
methylprednisolone
vascular endothelial growth factor
