阿托伐他汀对不同严重程度ARDS患者28 d病死率及HMGB1的影响研究  

Effect of Atorvastatin on 28-day Mortality and HMGB1 in Patients with Different Severity of ARDS

作　　者：林天来[1] 李才辉[1] 魏思灿[1] 杨雄志[1] 陈伟文[1] 于凯[1] LIN Tian-lai;LI Cai-hui;WEI Si-can;YANG Xiong-zhi;CHEN Wei-wen;YU Kai(Department of Intensive Medicine,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou,Fujian Province,362000 China)

机构地区：[1]福建医科大学附属泉州第一医院重症医学科,福建泉州362000

出　　处：《中外医疗》2018年第14期1-3,共3页China & Foreign Medical Treatment

基　　金：泉州市卫计委资助项目(2015年度)(泉卫计函[2015]248号)

摘　　要：目的探讨阿托伐他汀对不同严重程度ARDS患者28 d病死率及HMGB1的影响。方法方便选取2015年12月—2017年11月在该院ICU住院的ARDS患者120例,按照2011年德国柏林ARDS的诊断标准,分为轻度、中度、重度3组,每组40例,按照随机数字方法将各组ARDS患者分为对照组及实验组,各20例。所有对照组患者均施以常规方法治疗,实验组均施以口服或鼻饲阿托伐他汀治疗,观察3组患者在入住ICU第1、3、5、7、14、21、28天、死亡患者死亡当天急性生理与慢性健康(APACHⅡ)评分、血清HBMB1水平含量。结果 3组ARDS患者中的对照组在入住ICU第1、3、5、7、14、21、28天、死亡患者死亡当天的血清HBMB1水平含量不断上升,而实验组的血清HBMB1水平含量则不断下降;3组ARDS患者中的对照组患者死亡当天的APACHⅡ评分分别为(75.92±4.13)分、(79.64±5.07)分与(97.91±6.42)分,明显高于实验组的(45.08±0.92)分、(39.29±1.07)分与(30.21±0.98)分,差异有统计学意义(t=32.596、34.825、46.619,P=0.000)。结论阿托伐他可明显降低不同严重程度ARDS患者HMGB1水平,对患者具有重要作用,具有较高的临床推广价值。Objective This paper tries to investigate the effect of Atto vastatin on the fatality rate of 28 days and HMGB1 in patients with different severity of ARDS. Methods 120 ARDS patients with ICU in this hospital from December 2015 to November 2017 were convenient selected. According to the diagnostic criteria of ARDS in Berlin, Germany in 2011, the patients in each group were divided into three groups： mild, moderate and severe, with 40 cases in each group. The patients in each group were randomly divided into two groups： control group and experimental group. All the patients in the control group were treated with routine therapy, and the experimental group were treated with either oral or nasal feeding of Atto vastatin. The APACH II scores and serum HBMB1 levels were observed in the three groups of patients at the time of admission on days 1, 3, 5, 7, 14, 21, and 28 of the ICU, on the death day of the death patients. Results The levels of serum HBMB1 in the control group of the three groups of patients with ARDS increased on the day of death on the 1 st, 3 th, 5 th,7 th, 14 th, 21 st, and 28 th day of ICU admission, while the levels of serum HBMB1 in the experimental group decreased continuously. The APACH II scores on the day of death in the three groups of ARDS patients were（75.92 ±4.13） points,（79.64±5.07） points and（97.91±6.42） points, which were significantly higher than those of the experimental group（45.08±0.92）points. The scores were（39.29±1.07） points and（30.21±0.98） points, and the differences were statistically significant（t=32.596, 34.825, 46.619, P=0.000）. Conclusion Atorvastat can significantly reduce the level of HMGB1 in patients with different severity of ARDS. It plays an important role in patients and has a high clinical value.

关 键 词：阿托伐他汀 不同严重程度 急性呼吸窘迫综合征 28d病死率 血清HMGB1 

分 类 号：R5[医药卫生—内科学]