小剂量糖皮质激素在感染性休克患者中的应用  

Application of low-dose glucocorticoids in septic shock

作　　者：陈宏[1] 贾建国[1] 李非[2] 杨磊[1] 刘大川[1] 杨鹏[1] 孙家邦[2] 

机构地区：[1]首都医科大学宣武医院普外ICU,北京100053 [2]首都医科大学宣武医院普外科,北京100053

出　　处：《中国综合临床》2008年第8期802-804,共3页Clinical Medicine of China

摘　　要：目的探讨小剂量糖皮质激素对纠正感染性休克和改善患者预后的作用。方法感染性休克患者46例，24例未接受糖皮质激素治疗者为对照组，22例接受糖皮质激素治疗者为治疗组。除糖皮质激素应用外，其他治疗方法无明显差别。比较两组休克纠正和转归方面的差异。结果治疗组在治疗第7天时休克纠正率明显高于对照组（P〈0．05），而组间呼吸机治疗时间、住ICU时间、多器官功能不全综合征发生率和病死率方面差异无统计学意义（P〉0.05）。结论对顽固性感染性休克患者应用小剂量糖皮质激素可有效地纠正休克，更早地撤离血管活性药物，并明显降低炎症反应程度，但其对患者远期预后影响有待进一步研究。Objective To study the role of low-dose glucocorticoids in improving prognosis and adjusting septic shock, Methods A total of 46 patients with a confirmed diagnosis of septic shock were retrospectivley analyzed, 24 patients without glucocorticoids treatment were taken as control group; 22 patients with glucocorticoids as therapy group （ n = 22）. The two group received standard treatment for septic shock. Results The percentage of shock reversal on day 7 was higher in therapy group than that in control group （ P 〈 0.05 ）. However, there were not statistical significances in the duration of mechanical ventilation, the length of ICU stay,the incidence of multiple organ dysfunction syndrome （MODS） and mortality between the two groups （ P 〉 0.05 ）. Conclusion Low-dose glucocorticoids can effectively accelerate refractory septic shock reversal and vasopressor withdrawal. This seems to be related to the reduced production of CRP but the beneficial effects of low-dose steroids regimens on long-term outcome have not yet be determined.

关 键 词：感染性休克 糖皮质激素 血流动力学 多脏器功能不全综合征 

分 类 号：R459.7[医药卫生—急诊医学]