甲基强的松龙对肾移植术后巨细胞病毒肺炎机械通气呼吸力学影响  

Effect of methylprednisolone on pneumodynamics in cytomegalovirus (CMV) pneumonia after kidney transplantation during mechanical ventilation

作　　者：傅祖红[1] 张勇[1] 胡振红[1] 张波[1] 毛梅[1] 王冰冰[1] 墙建军[1] 曾群丽[1] 

机构地区：[1]广州军区武汉总医院呼吸内科,湖北武汉430070

出　　处：《中国医院药学杂志》2008年第21期1848-1850,共3页Chinese Journal of Hospital Pharmacy

摘　　要：目的:探讨甲基强的松龙(MP)对肾移植术后巨细胞病毒(CMV)重症肺炎机械通气患者呼吸力学的影响。方法:分析我院收治的33例肾移植术后CMV重症肺炎机械通气患者临床实验资料,其中12例加用了MP治疗(MP组),15例未加用MP治疗(对照组),观察2组患者机械通气呼吸力学参数及氧合情况。结果:MP组吸气阻力(Ri)、气道峰压(PIP)、平台压(Pplat)、平均气道压(Pm)、肺内分流量(Qs/Qt)分别显著低于对照组(P<0.05,P<0.01),肺顺应性(Cs,Cd)及氧合指数(PaO2/FiO2)显著高于对照组(P<0.05,P<0.01)。结论:MP治疗显著提高CMV重症肺炎患者肺顺应性,改善机械通气过程中呼吸力学特征及氧合情况,减少患者机械通气相关性肺损伤发生的可能性。OBJECTIVE To investigate the effect of methylprednisolone on pneumodynamics in cytomegalovirus （CMV） severe pneumonia after kidney transplantation during mechanical ventilation. METHODS Patients of CMV severe pneumonia after kidney transplantation were treated with methylprednisolone during mechanical ventilation. The parameters of pneumody- namics （Ri,PIP,Pplat,Pm,Cs,Cd） were monitored. The PaO2/FiO2 and Qs/Qt, were determined. RESULTS After the application of methylprednisolone, the level of Ri, PIP, Pplat, Pm, Qs/Qt decreased significantly, meanwhile, the Cs, Ca, PaO2/FiO2 increased significantly. CONCLUSION The treatment with methylprednisolone could improve obviously the status of pneumody- namies and oxygenation of CMV pneumonia after kidney transplantation during mechanical ventilation. As a result, the lung damage relation to ventilation would be prevented.

关 键 词：肾移植 巨细胞病毒 甲基强的松龙 机械通气 呼吸力学 

分 类 号：R969.1[医药卫生—药理学]