前列腺素E_1对ARDS肺动脉高压影响的临床观察

Clinical Observation of Prostaglandin EI on Pulmonary Hypertension in Patients with ARDS

目的:观察前列腺素E_1(PGE_1)对急性呼吸窘迫综合征(ARDS)病人肺循环及预后的影响。方法:15例ARDS病人随机分为PGE_1治疗组和对照组,在入重症监护治疗室(ICU)后给予常规治疗和呼吸机治疗,同时置入Swan-Ganz导管。每4小时监测1次MPAP,PCWP,PVR,CO。每日1次在FiO_2 100％条件下采外周动脉和混合静脉血测定血气,计算Qs/Qt共观察3天。计算入ICU时和住院6天后全部病人APACHEⅢ评分。结果:PGE_1(治疗)组MPAP、PVR均较治疗前和对照组明显下降,PCWP,Qs/Qt,CO两组相比无统计学意义。APACHE Ⅲ评分两组无变化。结论:PGE_1 10ng/(kg·min)可降低ARD6病人MPAP和PVR,但对预后无明显影响。

To investigate the effects of prostaglandin E1 (PGE1) on pulmonary circulation and prognosis in patients with acute respiratory distress syndrome (ARDS). Methods: Fifteen patients were randomly divided into treatment and control groups who underwent routine and ventilator therapy, and were inserted Swan-Ganz catheter to monitor MPAP, PCWP, PVR and CO every 4 hours. The arterial and mixed venous blood gas analysis were performed, and Qs/Qt was calculated every day for totally 3 days. APACHE III score of these patients were calculated when they came to ICU and six days later. Results: In tretment group, MPAP and PVR significantly decreased after treatment than pre-treatment and that of control group. There was no significant difference in PCWP, Qs/Qt, CO, and APACHE III between two groups. Conclusion: PGE1 10ng/(kg-min) can decrease MPAP and PVR in ARDS patients, but no significant effect on prognosis.