血必净治疗ARDS疗效及其对炎症相关细胞因子的影响.doc

血必净治疗ARDS疗效及其对炎症相关细胞因子的影响
【摘要】目的观察血必净注射液治疗急性呼吸窘迫综合征(ARDS)临床疗效及对炎症相关细胞因子的影响。方法将61例ARDS患者随机分为血必净组(n=30)和常规组(n=31),常规组患者按受常规治疗,血必净组患者接受常规治疗+血必净注射液50 ml静脉输注,2次/d。观察应用血必净对血清中肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)、IL-8含量的影响,比较2组患者治疗后7、14天血气分析指标。结果治疗后1天2组患者动脉血氧分压(PaO2)、氧合指数(PaO2/FiO2)及血清细胞因子间比较差异无统计学意义(P>),治疗后7、14天2组患者PaO2、PaO2/FiO2间差异有统计学意义(P<), 应用血必净后血清中TNF-α、IL-6、IL-8的含量及病死率均较常规治疗组降低,差异有统计学意义(P<)。结论血必净能够有效阻抑炎症反应,降低血清中TNF-α、 IL-6、 IL-8的含量,明显改善ARDS患者的症状和预后。
【关键词】血必净注射液急性呼吸窘迫综合征
Abstract: Objective To study the effects of Xuebijing on the inflammation-associated cytokines in patients with acute respiratory distress syndrome (ARDS). Methods 61 patients with ARDS were randomized into a control group (n=30, conventional treatment) and a test group (n=31, Xuebijing 50ml iv bid in addition to the conventional treatment). The patients were closely monitored with their serum levels of TNF-α, IL-6 and IL-8 and blood gas indexes checked on the 1 d, 7 d and 14 d of treatment. Results No significant changes in arterial oxygen and serum cytokines were noticed in the two groups on 1 d (P>). The PaO2 and PaO2/FiO2 got significantly higher in the test group than in the control group on 7 d and 14 d(P<). The serum levels of TNF-α, IL-6 sand IL-8 and the mo
rtality of ARDS were significantly decreased in the test group after the use of Xuebijing (P< or P<). Co