糖皮质激素治疗严重脓毒症的临床疗效观察  

A clinical research of low-dose glucorticoid administration in patients with severe sepsis

作　　者：孔令杰[1,2] 王新华[1] 商娜[1] 周荣斌[1] 

机构地区：[1]北京军区总医院急诊科,北京100700 [2]山西医科大学

出　　处：《临床急诊杂志》2012年第2期91-93,共3页Journal of Clinical Emergency

基　　金：首都医学发展科研基金课题(No:2009-1026)

摘　　要：目的:探讨氢化可的松琥珀酸钠对严重脓毒症患者临床疗效及预后的影响。方法:62例严重脓毒症患者随机分为治疗组32例与对照组30例,两组均给予常规治疗,在常规治疗的基础上治疗组加用小剂量氢化可的松琥珀酸钠,观察治疗前及治疗后72h、168hPCT和CRP;0h、24h、48h、168h行急性生理功能和慢性健康状况(APACHEⅡ)评分和序贯性器官衰竭评分(SOFA评分);比较两组28d病死率。结果:治疗前两组患者上述各指标差异无统计学意义(P>0.05)。治疗后两组各时点PCT和CRP浓度均明显下降(P<0.05),治疗后24h、48h、168hAPACHEⅡ评分、SOFA评分均明显下降(P<0.05),治疗组各时间点各指标的下降程度更为显著(P<0.05);但两组患者28d病死率差异无统计学意义。结论:小剂量氢化可的松琥珀酸钠能减轻严重脓毒症患者的炎症反应,对改善病情预后有一定的价值。Objective：To evaluate the efficacy of low-dose glucorticoid administration in patients with sepsis.Method：A total of 62 patients with severe sepsis were randomly divided into control group and treatment group.Routine therapy was given in both groups,and the treatment group was treated with additional injection of low-dose glucorticoid.PCT and CRP were measured and recorded before（baseline） and at 72 h,7 days after intervention.APACHEⅡ score and SOFA score were recorded before（baseline） and at 24 h,48 h and 7 days after treatment.Compare the incidence of 28 day mortality between the two groups.Result：There were no significant differences in both groups before treatment.All the indexes in both groups underwent decrease,while the decrease in patients who received glucorticoid was remarkable.However,28 day mortality was not improved between the two groups.Conclusion：Low-dose glucorticoid application can reduce inflammatory response in patients with severe sepsis and have value in improving the prognosis.

关 键 词：脓毒症 糖皮质激素 氢化可的松琥珀酸钠 

分 类 号：R692[医药卫生—泌尿科学]