低剂量长疗程糖皮质激素治疗急性呼吸窘迫综合征的效果及安全性研究

发布时间：2018-11-06 09:07

【摘要】：目的探讨低剂量长疗程糖皮质激素治疗急性呼吸窘迫综合征(ARDS)的效果及安全性。方法 2014年1月至2017年4月在呼吸科进行治疗的ARDS患者,随机分为两组,对照组25例患者采取无创或有创机械通气、抗生素、对症及支持治疗,糖皮质激素组25例患者在常规治疗的同时加用低剂量长疗程糖皮质激素。结果糖皮质激素组60 d内病死率(32%)低于对照组(60%)(P0.05)。糖皮质激素组28 d内无机械通气时间、28 d内无心、肝、肾功能衰竭时间均显著高于对照组(P0.05)。糖皮质激素组第14、28天氧合指数显著高于对照组而血清IL-8水平显著低于对照组(P0.05)。两组患者第7天空腹血糖、28 d内消化道出血人次、28 d内院感人次无显著差异(P0.05)。结论低剂量长疗程糖皮质激素能显著降低ARDS患者血清IL-8水平并改善预后。
[Abstract]:Objective to evaluate the efficacy and safety of low dose glucocorticoid in the treatment of acute respiratory distress syndrome (ARDS). Methods from January 2014 to April 2017, ARDS patients were randomly divided into two groups. 25 patients in the control group were treated with noninvasive or invasive mechanical ventilation, antibiotics, symptomatic and supportive therapy. 25 patients in glucocorticoid group were treated with low-dose and long-course glucocorticoid. Results the mortality rate (32%) in glucocorticoid group was lower than that in control group (60%) (P0.05). In the glucocorticoid group, the time of mechanical ventilation in 28 days, heart failure, liver and renal failure in 28 days were significantly higher than those in the control group (P0.05). The oxygenation index of the glucocorticoid group was significantly higher than that of the control group on day 14 and the serum IL-8 level was significantly lower than that of the control group (P0.05). There was no significant difference between the two groups in fasting blood glucose on the 7th day, gastrointestinal bleeding in 28 days and hospital sensation in 28 days (P0.05). Conclusion low-dose long-course glucocorticoid can significantly reduce serum IL-8 level and improve prognosis in patients with ARDS.
【作者单位】：江苏省连云港市第一人民医院徐州医科大学附属连云港医院南京医科大学连云港临床医学院江苏大学连云港临床医学院呼吸内科;
【基金】：江苏省卫计委面上科研课题(编号:H201558) 国家自然科学基金(编号:81300052) 中国博士后科学基金(编号:2015M570420) 连云港市521工程资助项目连云港市科技局资助课题(编号:SH1401)
【分类号】：R563.8

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