炎性反应与急性A型主动脉夹层术前并发肺损伤的相关性

发布时间：2018-10-24 09:57

【摘要】：目的检测患者血清IL-6和CRP水平,探讨急性A型主动脉夹层并发肺损伤与炎性反应的相关性。方法选择2007年1月至2016年2月医院收治的急性A型主动脉夹层患者216例,其中,男120例,女96例,平均年龄52.1岁。所有患者都经过心脏彩超等影像学检查并确诊,且在发病后立即住院,并治疗1周以上。在平静吸氧状态下,患者术前氧合指数≤200定义为肺损伤阳性。本研究根据此次定义把患者分为肺损伤阳性组和肺损伤阴性组,其中216例患者阳性组72例,阴性组144例。216例患者住院后每隔4 h抽取动脉血进行计算氧合指数。同时抽取血标本,用于统一检测C反应蛋白(CRP)、白介素6(IL-6)水平。评估患者血清CRP水平和IL-6水平与急性A型主动脉夹层并发肺损伤的关系。结果肺损伤阳性组与阳性组两组患者分别在性别、年龄、吸烟喝酒、常见慢性病等方面的差异均无统计学意义(P0.05);术前实验学检查、心脏彩超等几项检查差异均无统计学意义(P0.05);比较两组患者,肺损伤阳性组患者血清CRP峰值水平和IL-6峰值水平均显著高于肺损伤阴性组患者,差异有统计学意义(P0.05);进一步研究肺损伤患者血清CRP、IL-6水平与氧合指数的关系,发现夹层发生后,患者的氧合指数逐渐下降,而血清C反应蛋白和白介素6水平均迅速上升,达到峰值水平,而后,随着患者炎性反应减弱,氧合指数呈现上升的趋势。结论炎性反应在急性A型主动脉夹层引发肺损伤中起关键作用,随着患者患病时间的延长,患者血清C反应蛋白和白介素6水平与低氧血症关系密切。积极在术前予以抗炎治疗,可能会改善患者的氧合状况。
[Abstract]:Objective to investigate the correlation between pulmonary injury and inflammatory response in acute type A aortic dissection by detecting serum IL-6 and CRP levels. Methods 216 patients with acute type A aortic dissection were selected from January 2007 to February 2016, including 120 males and 96 females, with an average age of 52.1 years. All patients were diagnosed by echocardiography and were admitted to hospital immediately after onset and treated for more than 1 week. The preoperative oxygenation index 鈮，

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