PICCO监护仪观察ARDS肺血管内皮通透性的临床研究

Clinical Study on Pulmonary Endothelium Permeability in Patients with ARDS via PICCO

目的:通过脉波指示连续心排血量(PICCO)监护仪,观察急性呼吸窘迫综合征(ARDS)肺血管内皮通透性的变化并探讨影响肺血管内皮通透性(PPI)的因素。方法:选取ARDS患者采用PICCO监护仪,记录心输出量(CO)、血管外肺水(EVLW),并根据公式计算PPI。结果:观察期间ARDS患病时间平均患病时间(5．4±1.6)d, PaO2/FiO2为(137±24)mmHg,PEEP(9±5)cmH2O。急性生理和既往健康状况评分(APACHE)Ⅰ(20±5)。PPI分别与CO和EVLW存在正相关,相关系数分别为0．51和0．76(P均<0．01);PPI和PaO2/FiO2存在负相关,r=-0．71(P<0．01);CO和EVLW不存在相关性。结论:PPI受多种因素影响,且与ARDS患者病情程度相关。

Objective：. To evaluate the factors to pulmonary endothelium permeability via pulse-indicated continuous cardiac output （PICCO）. Methods： Fourteen patients with acute respiration distress syndrome （ARDS） was admitted in the study. The cardiac output （CO）, extra-vascular lung water （EVLW） was recorded. Then the pulmonary endothelium permeability index （PPI） was calculated according the formula . The blood gas was carried on at the same time also the PaO2/FiO2. Results： The patients were with ARDS at （5.4 ± 1.6） days, PaO2/FiO2 was （137 ± 24）mmHg, PEEP was （9 ± 5）cmH2Oo The score of APACHE Ⅱ was （20 ± 5）. There were positively correlation between PPI and CO, also the same between PPI and EVLW （P〈0.01） the coefficient correlation was 0.51 and 0.76 respectively. There are negative correlation between PPI and PaO2/FiO2 （r=-0.71） （P〈0.01）, There was no correlation between PPI and CO. The same result was observed in partial correlation. Conclusion： PPI was influenced by PaO2/FiO2 predominantly, which was one of factors of the severity of ARDS.