急性呼吸窘迫综合征患者血浆内皮素-1浓度变化的分析  

Analysis of changes in plasma endothelin-1 concentrations in patients with acute respiratory distress syndrome

作　　者：封珊[1] 王云鹏 成翕悦[1] 李丹丹[1] 崔如 靖博雅 李海滨[1] 方明星[2] 王智勇[2] Feng Shan;Wang Yunpeng;Cheng Xiyue;Li Dandan;Cui Ru;Jing Boya;Li Haibin;Fang Ming xing;Wang Zhiyong(Department of General Medicine,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China)

机构地区：[1]河北医科大学第三医院全科医学科,石家庄050051 [2]河北医科大学第三医院重症医学科,石家庄050051

出　　处：《中华麻醉学杂志》2023年第4期441-444,共4页Chinese Journal of Anesthesiology

基　　金：河北省医学科学研究重点课题计划项目(20190602)。

摘　　要：目的分析急性呼吸窘迫综合征(ARDS)患者血浆内皮素-1(ET-1)浓度的变化。方法创伤并发ARDS患者14例,男性8例,女性6例,年龄19~80岁,发病入ICU后,以ARDS柏林定义的标准,对患者ARDS严重程度进行分级。入ICU第1、3、5天取静脉血样,采用放射免疫法测血浆ET-1浓度;采用PiCCO技术测定肺血管通透性指数(PVPI);并进行多脏器功能障碍(MOD)评分及肺损伤评分(LIS),对血浆ET-1浓度与MOD评分、LIS及PVPI进行Spearman相关分析。结果轻度ARDS患者(n=5)MOD评分、LIS、PVPI及血浆ET-1浓度低于中度ARDS患者(n=9,P<0.05)。血浆ET-1浓度与MOD评分、LIS、PVPI均呈正相关(r=0.69、0.76、0.62,P<0.001)。结论在ARDS发病早期血浆ET-1浓度可反映患者肺血管通透性乃至病情严重程度,有必要进行动态监测。Objective To analyze the changes in plasma endothelin-1(ET-1)concentrations in the patients with acute respiratory distress syndrome(ARDS).Methods Fourteen patients with ARDS induced by trauma,8 males and 6 females,aged 19-80 yr,were studied.The severity of ARDS was graded according to the Berlin definition of ARDS after admission to intensive care unit(ICU).Venous blood samples were obtained on 1st,3rd and 5th days after admission to ICU,the plasma ET-1 concentrations were measured by radioimmunoassay,the pulmonary vascular permeability index(PVPI)was determined by PiCCO technique,and multiple organ dysfunction(MOD)score and lung injury score(LIS)were assessed.Spearman correlation of plasma ET-1 concentrations with MOD score,LIS and PVPI was analyzed.Results MOD score,LIS,PVPI and plasma ET-1 concentrations were significantly decreased in mild ARDS patients(n=5)as compared with moderate ARDS patients(n=9,P<0.05).The plasma ET-1 concentration was positively correlated with MOD score,LIS and PVPI(r=0.69,0.76,0.62,P<0.001).Conclusions Plasma ET-1 concentrations can reflect the pulmonary vascular permeability and even the severity of the disease in the early stage of ARDS,so it is necessary to carry out dynamic monitoring in the patients.

关 键 词：内皮缩血管肽1 血浆 急性呼吸窘迫综合征 

分 类 号：R563.8[医药卫生—呼吸系统]