摘要
目的探讨低剂量长疗程糖皮质激素治疗急性呼吸窘迫综合征(ARDS)的效果及安全性。方法2014年1月至2017年4月在呼吸科进行治疗的ARDS患者,随机分为两组,对照组25例患者采取无创或有创机械通气、抗生素、对症及支持治疗,糖皮质激素组25例患者在常规治疗的同时加用低剂量长疗程糖皮质激素。结果糖皮质激素组60 d内病死率(32%)低于对照组(60%)(P<0.05)。糖皮质激素组28 d内无机械通气时间、28 d内无心、肝、肾功能衰竭时间均显著高于对照组(P<0.05)。糖皮质激素组第14、28天氧合指数显著高于对照组而血清IL-8水平显著低于对照组(P<0.05)。两组患者第7天空腹血糖、28 d内消化道出血人次、28 d内院感人次无显著差异(P>0.05)。结论低剂量长疗程糖皮质激素能显著降低ARDS患者血清IL-8水平并改善预后。
Objective To explore the efficacy and safety of long-term use of low dose glucoeorticoids in acute respiratory distress syndrome(ARDS).Methods Fifty ARDS patients were randomly divided into two groups.The control group(25 patients)received non-invasive or invasive mechanical ventilation,antibiotics and support treatments.The glucocorticoids group(25 patients)received the same treatments plus long-term use of low dose glucoeortieoids.Results The mortality in glucocorticoids group(32%(8/25))was much lower than that in the control group(60%(15/25))(P〈0.05).The ventilator-free days and organ failure-free days within 28d in glucocorticoids group were significantly higher than those in the control group(P〈0.05).The oxygenation index and the serum IL-8 levels in glucocorticoids group at 14d and 28d were higher than those in the control group(P〈0.05).Compared to the control group,long-term use of low dose glucocorticoids in ARDS did not increase fasting blood-glucose at 7d,gastrointestinal bleeding and hospital infections within 28d.Conclusions Long-term use of low dose glucocorticoids in ARDS could reduce the serum IL-8 levels and improve the prognosis.
作者
史家欣
李家树
李小美
郭祥君
张峰
杨俊发
张嫚
霍雯
SHI Jiaxin;LI Jiashu;LI Xiaomei;GUO Xiangjun;ZHANG Feng;YANG Junfa;ZHANC Man;HUO Wen(De-partment of Respiratory Medicine,Lianyungang First People's Hospital,Affiliated Hospital of Xuzhou Medical Univer-sity,Nanjing Medical University and Jiangsu University,Lianyungang 222002,China)
出处
《实用医学杂志》
CAS
北大核心
2017年第18期3092-3095,共4页
The Journal of Practical Medicine
基金
江苏省卫计委面上科研课题(编号:H201558)
国家自然科学基金(编号:81300052)
中国博士后科学基金(编号:2015M570420)
连云港市521工程资助项目
连云港市科技局资助课题(编号:SH1401)
