大剂量甲泼尼龙治疗急性呼吸窘迫综合征的时机

The High-dose Methylprednisolone Treatment in Acute Respiratory Distress Syndrome

目的探讨急性呼吸窘迫综合征(ARDS)综合救治中使用大剂量甲泼尼龙的时机评估。方法收集对比2008至2011年入院且据其肺顺应性等评估后诊断为晚期ARDS的患者在使用及未使用大剂量甲泼尼龙治疗后的临床数据。结果 28例患者(实验组12例,对照组16例)诊断为晚期ARDS,其各参数基线水平一致。经治疗后,实验组各指标恢复速度比对照组快,但两组死亡率无差别。实验组感染致死率较对照组高。实验组痊愈与死亡者在年龄等方面有差异。结论肺顺应性等可用于评估晚期ARDS病人开始大剂量甲泼尼龙治疗的时机。病人的年龄、基础病情等可作为疗效预测因子。

Objective To investigate the time that start high-dose methylprednisolone treatment in acute respiratory distress syndrome （ARDS）. Methods The clinic dates were collected from the ARDS patients who met the study requirements from 2008 to 2011. The patients in control group were given the ordinary ARDS treatments and the experimental group was given an additional treatment of high-dose Methylprednisolone. Results 28 patients （ control group 16 ,experimental group 12） were diagnosed to be advanced stage ARDS according to their lung compliance, ect. After all treatments, the experimental group recovered faster than the control group, but there were no difference between the mortality. The infection induced death was higher in the experimental group. There were significant differences between the survivors and nonsurvivors of the experimental group in age, etc. Conclusion The lung compliance, ect. may be used to evaluate the time that start high-dose methylprednisolone treatment of ARDS. The age, basic stage of illness, ect. may predict the curative effect.