血管内皮细胞损伤与脓毒症休克的相关性

发布时间：2018-05-12 11:17

本文选题：脓毒症休克 + 血管内皮细胞　；参考：《实用医学杂志》2017年15期

【摘要】：目的探讨血管内皮细胞损伤与脓毒症休克的相关性和可能的临床价值。方法 2016年1-12月入住ICU的感染患者72例,按是否合并脓毒症休克分为两组。A组(34例):有明确感染灶但未合并脓毒症休克患者;B组(38例):脓毒症休克患者。分别于入ICU时(T0)及入ICU后24 h时(T1),测定两组患者CEC数量、血浆v WF以及血浆NO含量等指标,同时记录患者血压变化情况。结果与A组比较,B组患者T0及T1时点的CEC数量及血浆v WF含量均高于A组(P0.01),而血浆NO浓度则低于A组(P0.05)。与T0比较,B组T1时点的CEC数量及血浆v WF含量均显著升高(P0.05)、血浆NO浓度则显著降低(P0.05),而A组相应指标均未见明显变化(P0.05)。B组治疗过程中血流动力学不稳定,全部使用了较大剂量的血管活性药;A组患者生命体征基本平稳,仅5例患者短暂使用了小剂量的血管活性药(多巴胺3~5μg/kg)。各时点的平均动脉压(MAP)B组均明显低于A组(P0.05)。住院期间死亡率:B组18%vs.A组0%(P0.05)。结论脓毒症休克患者存在明显的血管内皮细胞损伤,损伤程度与病情严重程度具有相关关系。
[Abstract]:Objective to investigate the relationship between vascular endothelial cell injury and septic shock and its possible clinical value. Methods Seventy-two patients admitted to ICU from January to December 2016 were divided into two groups according to whether they were complicated with septic shock. Group A was divided into two groups: group A (n = 34): group B (n = 38) with definite infection focus but without sepsis shock (n = 38): septic shock (n = 38). The levels of CEC, vWF and no were measured at 24 h after ICU and 24 h after ICU, respectively. The changes of blood pressure were recorded at the same time. Results compared with group A, the amount of CEC and the content of vWF in plasma of group B were higher than those of group A at T 0 and T 1, while the concentration of no in group B was lower than that in group A (P 0.05). Compared with T0, the quantity of CEC and the content of vWF in plasma of group B were significantly higher than those of group B at T1, while the concentration of no in plasma decreased significantly (P 0.05), while in group A there was no significant change in hemodynamic instability during treatment. The vital signs of all patients in group A were stable, and only 5 patients were given small doses of vasoactive drugs (dopamine 3 渭 g / kg 路kg ~ (-1). The mean arterial pressure at each time point in MAPB group was significantly lower than that in A group (P 0.05). The mortality rate during hospitalization was 0. 05% in 18%vs.A group. Conclusion there is obvious vascular endothelial cell injury in septic shock patients, and the degree of injury is related to the severity of the disease.
【作者单位】：广东省人民医院(广东省医学科学院) 广东省心血管病研究所麻醉科;广东省人民医院SICU;
【基金】：广东省卫生厅基金资助课题(编号:A2016051)
【分类号】：R459.7

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