摘要
目的通过观察盐酸戊乙奎醚（PHC）对急性肺损伤（ALI）的临床效果和外周动脉血ELR＋趋化因子变化规律的影响，探讨ELR＋趋化因子在PHC治疗AU中的作用。方法ISS≥16的多发伤患者按诊断ALI次序编号，完全随机分组：实验组（n=22），入组后立即予PHC1mg肌肉注射；对照组（n=21），不予PHC，两组其他治疗相同。在5个时间点（0、6、12、24、48h）观察记录APACHEⅡ量表中的指标，检测每个时间点动脉血中趋化因子：白细胞介素-8（IL-8）、人上皮中性粒细胞活化肽（ENA-78）、生长相关性癌基因（GRO-α），进行统计分析。结果PHC实验组ALI患者较对照组PaO2、PaO2／FiO2明显改善。趋化因子浓度-时间曲线图中，无论是对照组还是实验组，IL-8、ENA-78、GRO-α在12h内都随时间而升高，实验组自12h开始下降，并且下降幅度明显大于对照组，48h明显低于对照组。PHC使实验组患者血浆IL-8、ENA-78、GRO-α下降更明显，并且在2d内入组者下降幅度更大。PHC在24、48h对ISS≥25患者的IL-8下降作用大于对照组。结论PHC对ALI有一定的临床治疗效果，作用机制可能和PHC降低ELR＋趋化因子有关。
Objective To observe the clinical effects of penehyclidine hydrochloride （PHC） on acute lung injury （ALI） and its influences on ELR＋ chemokines in peripheral arterial blood in order to evaluate the role of ELR＋ chemokines in ALl with PHC treatment. Methods Multiple trauma patients with injury severity score （ISS） ≥ 16 were randomized into two groups： PHC group （n = 22） and control group （n = 21 ）. Patients in both groups received similar treatments except that the patients in PHC group were given 1 mg PHC intramuscular injection. Acute Physiology ＆ Chronic Health Evaluation （APACHE） Ⅱ score was calculated and peripheral arterial blood samples were taken at 0, 6, 12, 24 and 48 h after grouping. Serum levels of interleukin - 8 （ IL - 8 ）, epithelial neutrophil - activating peptide-78 （ENA-78） and growth- regulated oncogene- α （GRO-α） were measured by ELISA. Results PaO2, PaO2/FiO2 of the ALI patients in PHC group improved significantly compared with the control group. IL-8, ENA-78, GRO-α increased in both PHC group and control group until 12 h. The levels of the ehemokines decreased after 12 h and declined more obviously in the PHC group than in the control group especially at 48 h. In patients with ISS ≥ 25, the decrease of the IL - 8 was more obvious in PHC group than in the control group at 24 and 48 h. Conclusion PHC is helpful in the clinical treatment of ALI, which may be connected with the decreases of ELR ≥chemokines induced by PHC.
出处
《中国急救医学》
CAS
CSCD
北大核心
2012年第11期966-970,共5页
Chinese Journal of Critical Care Medicine
基金
南京军区122工程重点培养对象资助项目（JQZD200905）
南京军区南京总医院重点课题（2008002）
