小剂量糖皮质激素治疗感染性休克的疗效及对血清感染标志物水平的影响  

Clinical effect of low-dose glucocorticoid on treatment of septic shock and influence on serum infection markers

作　　者：时俊霞[1] 毕勇志[1] 李勇[1] 王芳[1] 杨素霞[2] 

机构地区：[1]河南大学第一附属医院急诊科,河南开封475001 [2]河南大学淮河医院肾内科,河南开封475000

出　　处：《中华医院感染学杂志》2016年第17期3872-3874,共3页Chinese Journal of Nosocomiology

基　　金：河南省科技厅基金资助项目(2013980945L)

摘　　要：目的观察小剂量糖皮质激素治疗感染性休克的临床疗效,并探讨其对患者血清感染标志物水平的影响程度,为感染性休克的治疗提供参考依据。方法选取2012年2月-2015年9月医院收治的60例感染性休克患者为研究对象,将其随机分为对照组和观察组,各30例,对照组患者采用常规治疗,观察组患者在此基础上加用小剂量糖皮质激素,对比分析两组患者的血乳酸清除率、APACHEⅡ评分、呼吸机使用时间、病死率、治疗前后的血清感染标志物水平。结果观察组的血乳酸清除率、APACHEⅡ评分、呼吸机使用时间及病死率分别为46.67%、(12.25±1.28)分、(11.67±1.20)d及10.00%,均好于对照组的66.67%、(15.95±1.37)分、(18.25±1.45)d及26.67%,治疗后12、24、48h观察组的血清感染标志物水平也均好于对照组,差异均有统计学意义(P<0.05)。结论小剂量糖皮质激素治疗感染性休克的临床疗效较好,且对于患者的血清感染标志物水平也有积极的改善作用。OBJECTIVE To observe the clinical effect of low-dose glucocorticoid on treatment of septic shock and explore the influence on levels of serum infection markers so as to provide guidance for clinical treatment of the septic shock.METHODS A total of 60 patients with septic shock who were treated in hospitals from Feb 2012 to Sep 2015 were recruited as the study objects and randomly divided into the control group and the observation group,with 30 cases in each group.The control group was given conventional therapy,while the observation group was treated with additional low-dose glucocorticoid based on the treatment of the control group.The clearance rate of blood lactate,APACHEⅡ score,time of use of ventilator,mortality rate,and levels of serum infection markers before and after treatment were observed and compared between the two groups of patients.RESULTS The clearance rate of blood lactate of the observation group was 46.67%,lower than 66.67% of the control group;the APACHEⅡ score of the observation group was（12.25±1.28）points,lower than（15.95±1.37）points of the control group;the time of use of ventilator of the observation group was（11.67±1.20）days,shorter than（18.25±1.45）days of the control group;the mortality rate of the observation group was 10.00%,lower than 26.67% of the control group.The levels of serum infection markers were significantly better in the observation group than in the control group after the treatment for 12,24,and 48hours（P〈0.05）.CONCLUSION The low-dose glucocorticoid can achieve significant clinical effect on treatment of the septic shock and actively improve the levels of serum infection markers of the patients.

关 键 词：小剂量糖皮质激素 感染性休克 临床疗效 血清感染标志物 

分 类 号：R977.1[医药卫生—药品]