小牛脾提取物注射液联合应用甲泼尼龙对ARDS患者炎性因子及治疗效果的影响  

Effect of calf spleen extractive injection and methylprednisolone on inflammatory factors and efficacy in patients with acute respiratory distress syndrome

作　　者：黄慧[1] 朱伟旺[1] 李伟坚[1] 

机构地区：[1]惠州市中心人民医院呼吸内科,516001

出　　处：《国际呼吸杂志》2017年第3期198-201,共4页International Journal of Respiration

基　　金：惠州市科技计划医疗卫生项目（2013Y002）

摘　　要：目的 探讨小牛脾提取物注射液联合应用甲泼尼龙 （甲基强的松龙）对 ARDS 患者炎性因子及治疗效果的影响。方法 选取 2012 年 1 月至 2015 年 12 月在我院收治的 ARDS 患者 60 例,将患者按照数字分配原则随机分为 A 、 B 、 C 组,各 20 例。 3 组患者均给予常规治疗,在常规治疗基础上 B 组患者给予甲泼尼龙 80mg / d 静脉注射 7d 。 C 组给予小牛脾提取物注射液联合应用甲基强的松龙治疗,观察 3 组患者治疗前、治疗后 3d 、 7d 血浆 IL-8 、肿瘤坏死因子 α （ TNF-α ）及降钙素原（ PCT ）变化水平,记录 3 组患者治疗前后机械通气时间、氧合指数、急性生理和慢性健康评分系统 Ⅱ评分 （ APACHEⅡ 评分）结果 治疗前 3 组患者 IL-8 、 TNF-α 、 PCT 水平比较,差异无统计学意义（ P ＞0.05 ）。治疗后 3d 、 7dB 组、 C 组患者 IL-8 、 TNF-α 、 PCT 水平低于 A 组, C 组上述指标低于B 组 （ P ＜0.05 ）。治疗前 3 组患者氧合指数、 APACHEⅡ 评分比较,差异均无统计学意义 （ P ＞0.05 ）。治疗后 B 组和 C 组氧合指数高于 A 组, C 组高于 B 组 （ P ＜0.05 ）; APACHEⅡ 评分和机械通气天数低于 A 组, C 组低于 B 组 （ P ＜0.05 ）;三组患者的住院时间与发生死亡的情况差异无统计学意义 （ P ＞0.05 ）。结论 小牛脾提取物注射液联合应用甲基强的松龙可以明显抑制患者炎性因子水平,有助于提高治疗效果。Objective To discuss the effect of calf spleen extractive injection and methylprednisolone on inflammatory factors and efficacy in patients with acute respiratory distress syndrome（ARDS）. Methods 60 ARDS patients in our hospital from January 2013 to December 2015 were selected,and they were randomly divided groups A, B, C, each of 20 cases. All patients were given conventional therapy,group B was given intravenous injection of Methylprednisolone, 80 mg/d, group C was given intravenous injection calf spleen extractive injection and Methylprednisolone All patients treated for 7 days. The levels of interleukin-8 （IL-8）, tumor necrosis factor -α （TNF-α） and procalcitonin （PCT） were detected before treatment 3 days and 7 days after treatment, duration ventilation time and oxygenation index, Acute physiology and Chronic Healtho Evaluation Ⅱ （APACHE Ⅱ ） score, were observed. Results Before treatment, IL-8, TNF-α, PCT levels in 3 groups of patients were compared, the difference was not statistically significant （ P 〉0.05）. After treatment, 3 days, 7days, B group, C group of patients with IL8, TNF-a, PCT levels were lower than the A group, C group, the above indicators were lower than the B group （ P 〈0.05）. There was no significant difference in oxygenation index （ P 〉0.05） between the 3 groups before treatment. After treatment, the oxygenation index of B group and C group was higher than that of A group, C group was higher than B group （ P 〈0.05）; APACHEⅡ score and duration of mechanical ventilation was lower than that of A group, C group was lower than in B group （ P 〈0.05） ;The hospitalization of three groups of patients had no significant difference with the occurrence of death, the result had no significant difference （P 〉 0.05 ）. Conclusions Methylprednisolone can significantly inhibit the inflammatory factor, help to improve the therapeutic effect in patients with ARDS, and the effect of calf spleen extractive injection and Methylprednisolone is bett

关 键 词：呼吸窘迫综合征 急性 甲基强的松龙 炎性因子 

分 类 号：R563.8[医药卫生—呼吸系统]