PGI_2雾化吸入在急性呼吸窘迫综合征中的治疗作用

Effects of aerosolized prostacyclin I_2 on acute respiratory distress syndrome

目的观察雾化吸入前列腺I(2PGI2)对急性呼吸窘迫综合征(ARDS)患者血流动力学、动脉血气、氧合状况的影响,评价其治疗效果。方法2006年11月～2008年12月共救治ARDS患者55例,随机分为PGI2治疗组(28例)和对照组(27例)。治疗组在入院24h后雾化吸入PGI230ng/kg·min,每次25min,每天10次,连续使用7d。从血流动力学变化、动脉血氧分压(PaO2)、呼吸机通气时间及生存率等方面进行比较。结果治疗组PaO2、Pa02/FiO2恢复时间较对照组早(P<0.01,P<0.05),呼吸机支持时间显著短于对照组(P<0.01),生存率显著高于对照组(P<0.05)。结论PGI2能有效降低肺动脉压和肺血管阻力,增加心排量和氧供,提高其生存率,对ARDS有较好疗。

Objective To observe the effects of aerosolized prostacyclin I2 （PGI,）on hemodynamics,blood gas and oxygenation in patients with acute respirotary disorder syndrome （ARDS）. Methods From November 2006 to December 2008,55 patients with ARDS were randomly divided into PGI2 group consisted of 28 cases and control group consisted of 27 cases. PGI2 group received aerosolizing PGI,_ for 30 ng/kg· min for 25 minutes 24th hour after admission, ten times a day and continued for 7 days. In both groups,hemodynamics,arterial blood oxygen pressure,duration of assisted ventilation and survival rate were compared. Results Compared with the control group , survival rate in the PGI2 group was significantly higher （P〈0.05）,the total duration of assisted ventilation were significantly shorter （P〈0.01）. PaO, and PaO2/FiO2 were improved in beth groups,but the recovery time in the PGI2 group was shorter than that in the control group（P〈0.01 ,P〈0.05）. Condufion PGI2 could decrease pulmonary arterial pressure and pulmonary vascular resistance but increase cardiac output and oxygen delivery, and increase the survival rate in patients with ARDS.