前列腺素E_1对急性呼吸窘迫综合征病人氧供和氧耗的影响

Effects of prostaglandin E_1 on oxygen delivery and consumption in patients with ARDS

目的 观察前列腺素 E1 (PGE1 )对呼吸窘迫综合征 (ARDS)病人氧供和氧耗及预后的影响。方法 将 18例 ARDS病人 ,根据治疗情况和预后分为 4组 :对照生存组 (CS) (n=4) ,对照死亡组 (CD) (n=4) ,PGE1 治疗生存组 (PS) (n=6 ) ,PGE1 治疗死亡组 (PD) (n=4)。所有病人入 ICU后接受常规治疗和呼吸机治疗 ,均用异丙酚加芬太尼混合液或咪唑安定加芬太尼混合液持续镇静。在入ICU时置入 Swan- Ganz导管 ,监测血液动力学的同时采外周动脉和混合静脉血测定血气 ,计算DO2 I、VO2 I、ERO2 。并在入 ICU后第 1天、第 2天、第 3天及出 ICU时重复测定上述指标。结果 在ICU治疗期间 ,对照组 (CS、CD)病人的 DO2 无明显变化 ,CD组 VO2 和 ERO2 均上升 ,而 CS组 VO2和 ERO2 均下降。治疗组 (PD、PS组 ) DO2 、VO2 均升高 ,而 ERO2 无明显变化。结论 PGE1 30 ng·kg- 1 · m in- 1 可改善 ARDS病人的氧供和氧耗 ,但对生存率无明显影响。

Objective To investigate the effects of prostaglandin E 1(PGE 1) on oxygen delivery and consumption in patients with acute respiratory distress syndrome(ARDS).Methods Eighteen patients with ARDS were divided into four groups:control survived(n=4);control died(n=4);PGE 1 survived(n=6);PGE 1 died(n=4).Hemodynamics were measured through Swan Ganz catheter and DO 2,VO 2 and ERO 2 were calculated at the following time point:(1)admission to ICU;(2)the first day in ICU;(3)the second day in ICU;(4)the third day in ICU;(5)discharge from ICU.Results In control died group, VO 2, and ERO 2 increased but DO 2 remained unchanged.In control survived group, VO 2 and ERO 2 decreaced, and DO 2 kept stable.In PGE 1 group, VO 2,and DO 2 increased and ERO 2 kept stable.Conclusion PGE 1 30ng·kg -1 ·min -1 can improve oxygen delivery and consumption,but not increase survival rate of in patients with ARDS.