抗血小板治疗对溺水型急性肺损伤的影响及其临床意义  

Effects of anti-platelet therapy on drowning-induced acute lung injury and its clinical significance

作　　者：陈海滨 陈雄伟[1] 彭发坤[2] Chen Haibin;Chen Xiongwei;Peng Fakun(Department of Emergency(Internal Medicine),Pan’an People’s Hospital of Zhejiang Province,Pan’an 322300,China)

机构地区：[1]磐安县人民医院急诊科(内科),浙江省磐安322300 [2]磐安县人民医院ICU,浙江省磐安322300

出　　处：《中华航海医学与高气压医学杂志》2020年第6期726-729,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的探究抗血小板治疗对溺水型急性肺损伤(acute lung injury,ALI)患者血清中D-二聚体、N末端B型钠尿肽前体(N-terminal pro-B-type natrigtetic peptide,NT-pro BNP)及血小板水平的影响,并分析其临床意义。方法回顾性选取浙江省磐安县人民医院2014年6月至2019年6月收治的90例溺水误吸导致的ALI患者作为研究对象。根据抗血小板药物服用情况分为观察组和对照组。同时选取40例健康体检者作为健康组,用于与ALI患者进行比较。测定观察组和对照组患者血清D-二聚体、NT-pro BNP及血小板水平,记录急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)发生情况。Pearson相关性分析D-二聚体、NT-pro BNP及血小板水平与氧合指数的相关性。结果ALI患者血清D-二聚体、NT-pro BNP及血小板水平明显高于健康组患者。观察组患者血清D-二聚体、NT-pro BNP及血小板水平均明显低于对照组,差异有统计学意义(P<0.05);氧合指数(oxygenation index,OI)及ARDS发生率与对照组相比均明显降低,差异有统计学意义(P<0.05)。Pearson相关性分析发现,血清D-二聚体、NT-pro BNP及血小板水平与氧合指数均显著负相关(P<0.05);其中D-二聚体与OI相关性最强(r=-0.637),NT-pro BNP及血小板与OI中等相关(r=-0.512及-0.464)。结论抗血小板治疗可降低ALI患者血清D-二聚体、NT-pro BNP及血小板水平,增加OI,改善肺损伤,从而有效减少ARDS的发生。Objective To explore the effects of anti-platelet therapy on the levels of serum D-dimmer,N-terminal pro-B-type natriuretic peptide(NT-pro BNP),and platelet(PLT)of the patients with drowning-induced acute lung injury(ALI),and to analyze its clinical significance.Methods A total of 90 patients with ALI caused by drowning and aspiration admitted into Pan’an People’s Hospital of Zhejiang Province from June 2014 to June 2019 were included into a retrospective analysis and divided into observation group and control group according to the administration of anti-platelet drug.At the same time,40 healthy people were selected as the healthy group for the comparison with the ALI patients.The levels of serum D-dimmer,NT-proBNP,and PLT in the observation group and the control group were detected.The incidence rate of acute respiratory distress syndrome(ARDS)was also recorded.The correlations of the levels of D-dimmer,NT-proBNP,and PLT,with oxygenation index(OI)were analyzed by Pearson correlation analysis.Results The levels of serum D-dimer,NT-pro BNP,and PLT of the patients with ALI were obviously higher than those in the healthy group.After the anti-platelet therapy,the levels of serum D-dimmer,NT-pro BNP,and PLT of the patients in the observation group were significantly lower than those in the control group(P<0.05),and the OI and the incidence rate of ARDS were all significantly decreased(P<0.05).Pearson correlation analysis indicated that levels of serum D-dimmer,NT-pro BNP,and PLT were significantly negatively correlated with OI(P<0.05);the level of serum D-dimmer presented the strongest correlation with OI(r=-0.637),while the levels of NT-pro BNP and PLT were mediumly related with OI(r=-0.512 and-0.464).Conclusion Anti-platelet therapy can decrease the levels of serum D-dimmer,NT-pro BNP,and PLT of ALI patients and increase the oxygenation index,and therefore,improve lung injury,thus effectively reducing the occurrence of ARDS.

关 键 词：阿司匹林 抗血小板治疗 急性肺损伤 临床意义 

分 类 号：R563[医药卫生—呼吸系统] R649.3[医药卫生—内科学]