盐酸戊乙奎醚对急性肺损伤患者炎症因子的影响

摘要

目的 探讨盐酸戊乙奎醚对急性肺损伤(ALI)患者炎症因子的影响.方法 ALI患者96 例,随机分为治疗组和对照组各48例.治疗组给予常规治疗,加用盐酸戊乙奎醚注射液1 mg,im,q12 h或q8h,首剂量可加倍,至少连续应用2 d;对照组采用常规治疗.比较两组患者治疗前后肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、降钙素原(PCT)、氧合指数(PaO2/FiO2)、肺损伤评分(LIS)及急性生理和慢性健康状况评分(APACHEⅡ)的变化,并记录两组患者的机械通气时间、重症监护室(ICU)治疗时间、急性呼吸窘迫综合征(ARDS)发生率及ICU内死亡率.结果 治疗过程中治疗组TNF-α、IL-6、hs-CRP、PCT、LIS、APACHEⅡ均低于对照组,PaO2/FiO2高于对照组(P<0.05或 P<0.01);治疗组患者的机械通气时间、ICU治疗时间短于对照组(均P<0.05).治疗组和对照组的ARDS发生率分别为20.8%,39.6%(P<0.05);ICU内死亡率分别为12.5%,31.2%(P<0.05).结论 盐酸戊乙奎醚用于ALI患者能有效改善氧代谢,可以调控肺部炎症反应,改善患者预后.%Objective To study the influence of penehyclidine hydrochloride(PHC)on inflammatory factors in patients with acute lung injury(ALI).Methods Total of 96 patients with ALI were randomly divided into treatment group(48 cases)and control group(48 cases).Patients in the treatment group were given conventional therapy,plus penehyclidine hydrochloride injection 1 mg,im,q12 h or q8h,the first dose could be doubled,at least 2 days of continuous application;Patients in the control group were received conventional therapy.Tumor necrosis factor α (TNF-α),interleukin-6 (IL-6),high sensitive C reactive protein (hs-CRP),calcitonin (PCT),oxygenation index (PaO2/FiO2),lung injury score (LIS) and acute physiology and chronic health status score (APACHE II) of patients on each time point were compared between the two groups before and after treatment,and mechanical ventilation time,intensive care (ICU) treatment time,acute respiratory distress syndrome (ARDS) and ICU mortality were recorded.Results On each time point of treatment,TNF-α,IL-6,hs-CRP,PCT,LIS,APACHE II in treatment group were significantly lower than that of control group (P<0.05),PaO2/FiO2 was significantly higher than that of control group(P<0.01).The mechanical ventilation time,ICU treatment time in treatment group were shorter than that of control group(all P<0.05),The incidence of ARDS in treatment group and control group was 20.8% and 39.6%,respectively(P<0.05);ICU mortality rate was 12.5% and 31.2%,respectively(P<0.05).Conclusion Penehyclidine hydrochloride can effectively improve the oxygen metabolism in acute lung injury,regulate the pulmonary inflammatory response and improve the prognosis of patients.