激素替代治疗在ICU严重脓毒症和脓毒性休克中的效果分析  

Effect analysis of hormone replacement therapy in ICU patients with severe sepsis and septic shock

作　　者：廉文清[1] LIAN Wen-qing(Department of Critical Care Medicine,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院重症医学科,100034

出　　处：《中国实用医药》2025年第1期98-101,共4页China Practical Medicine

摘　　要：目的分析重症加强护理病房(ICU)严重脓毒症和脓毒性休克患者应用激素替代治疗的效果。方法67例ICU严重脓毒症和脓毒性休克患者,以多阶段抽样法分为试验组(35例)与参照组(32例)。参照组实施常规治疗,试验组在常规治疗基础上实施激素替代治疗。对比两组血流动力学相关指标、外周血免疫功能指标、血清炎性因子及临床疗效。结果治疗后,试验组平均动脉压(114.52±9.63)mm Hg(1 mm Hg=0.133 kPa)高于参照组的(97.46±7.85)mm Hg,心率(85.17±5.33)次/min、血乳酸(2.74±0.43)mmol/L均低于参照组的(96.43±6.81)次/min、(3.22±0.67)mmol/L,数据经验证符合统计学差异(P<0.05)。两组治疗前后外周CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+)组间对比,数据经验证均不符合统计学差异(P>0.05);两组治疗后外周血CD4^(+)、CD4^(+)/CD8^(+)均高于治疗前,CD8^(+)均低于治疗前,数据经验证符合统计学差异(P<0.05)。治疗后,试验组白细胞介素-6(IL-6)(39.21±2.64)pg/ml、超敏C反应蛋白(hs-CRP)(22.47±3.19)mg/L、降钙素原(PCT)(0.83±0.19)ng/ml均低于参照组的(63.54±5.25)pg/ml、(38.62±5.24)mg/L、(1.37±0.28)ng/ml,数据经验证符合统计学差异(P<0.05)。试验组临床治疗总有效率97.14%高于参照组的81.25%,数据经验证有统计学差异(P<0.05)。结论ICU严重脓毒症和脓毒性休克患者实施激素替代治疗能有效改善血流动力,调节心率及血压,减轻机体炎症反应,提升治疗效果,对其机体免疫功能并未造成影响。Objective To analyze the effect of hormone replacement therapy in intensive care unit(ICU)patients with severe sepsis and septic shock.Methods 67 cases of ICU patients with severe sepsis and septic shock were divided into experimental group(35 cases)and a reference group(32 cases)by multi-stage sampling method.The reference group received conventional treatment,and the experimental group received hormone replacement therapy on the basis of conventional treatment.The hemodynamic indexes,peripheral blood immune function indexes,serum inflammatory factors and clinical efficacy of the two groups were compared.Results After treatment,the mean arterial pressure of(114.52±9.63)mm Hg(1 mm Hg=0.133 kPa)in the experimental group was higher than(97.46±7.85)mm Hg in the reference group;the heart rate and blood lactate in the experimental group were(85.17±5.33)beats/min and(2.74±0.43)mmol/L,which were lower than(96.43±6.81)beats/min and(3.22±0.67)mmol/L in the reference group;the data were verified to be statistically different(P<0.05).Comparison of peripheral blood CD4^(+),+CD8 and CD4^(+)/CD8^(+)between the two groups before and after treatment,and the data were verified not to be statistically significant(P>0.05).After treatment,the peripheral blood CD4^(+),CD4^(+)/CD8^(+)+in both groups were higher than those before treatment,and CD8 was lower than that before treatment;the data were verified to be statistically different(P<0.05).After treatment,the experimental group had an interleukin-6(IL-6)of(39.21±2.64)pg/ml,a hypersensitive C-reactive protein(hs-CRP)of(22.47±3.19)mg/L and a procalcitonin(PCT)of(0.83±0.19)ng/ml,which were lower than(63.54±5.25)pg/ml,(38.62±5.24)mg/L and(1.37±0.28)ng/ml in the control group,and the data were verified to be statistically different(P<0.05).The total effective rate of clinical treatment in the experimental group was 97.14%,which was higher than 81.25%in the reference group,and the data were verified to be statistically different(P<0.05).Conclusion Hormone replacement therapy

关 键 词：激素替代治疗 重症加强护理病房 严重脓毒症 脓毒性休克 

分 类 号：R47[医药卫生—护理学]