亚低温治疗对急性呼吸窘迫综合征(ARDS)患者血小板活化物CD62P、PAC-1水平的影响分析

Effect of Mild Hypothermia on the level of Platelet Activator CD62P,PAC-1 in Patients with Acute Respiratory Distress Syndrome(ARDS)

目的探讨亚低温治疗对急性呼吸窘迫综合征(ARDS)患者血小板活化物CD62P(P-选择素)、PAC-1(血小板膜糖蛋白Ⅱb/Ⅲa)表达水平变化及患者预后的影响。方法 46例急性呼吸窘迫综合征患者随机分配为亚低温治疗组23例和常温治疗对照组23例。亚低温治疗组在常规治疗基础上行亚低温治疗,直肠温度控制在32.5～34.5℃,持续4～5天;对照组仅进行常规治疗。同时监测两组患者的血小板活化物CD62P和PAC-1的表达水平。最终通过发病1周内MODS(多器官功能障碍综合征)发生率评价预后。结果与对照组比较,亚低温治疗组患者的血小板活化物CD62P和PAC-1的表达水平显著下降(P<0.01),MODS发生率也明显下降(P<0.05)。结论亚低温治疗可显著抑制急性呼吸窘迫综合征患者血小板活化物CD62P和PAC-1的表达,有效的保护了其他重要脏器的功能,从而降低了患者MODS的发生率,改善预后。

Objective To investigate the effect of mild hypothermia in patients with acute respiratory distress syndrome（ARDS） on platelet activator - CD62P（ P - selectin）, PAC - 1 （ Platelet glycoprotein Ⅱb /Ⅲ a） ＇ s expression and the prognosis of the patients. Methods Forty - six cases of acute respiratory distress syndrome were randomly assigned to hypothermia treatment group. Totally 23 ca- ses were as the control group. Patients in the hypothermia group were treated with mild hypothermia therapy on the basis of the conventional therapy, and the rectal temperature was controlled at 32.5 - 34.5~C for 4 - 5 days. People in the control group received conventional ther- apy alone. At the same time we monitored the platelet activator CD62P and PAC - 1 ＇s expression of patients＇ level in the 2 groups. At last we evaluated the prognosis by the incidence of MODS in a week from the onset. Results Compared with the control guoup,the platelet ac- tivator CD62P and PAC -1 ＇s expression level of the hypothermia group significantly decreased（P 〈 0.01 ） , and the incidence of MODS significantly decreased too （ P 〈 0.05 ）. Conclusion Hypothermia treatment can significantly inhibit the platelet activator CD62P and PAC - 1 ＇s expression level in the patients of ARDS. Thereby it effectively protects the other vital organs function, the incidence of MODS de- creases and the prognosis is improved.