肝移植术后早期免疫抑制剂对急性呼吸窘迫综合征的影响

The affection of immunosuppressive agents in OLT with ARDS

目的 观察原位肝移植术 (OLT)后早期应用免疫抑制剂治疗对ARDS发生发展的影响。方法 回顾性分析 17例肝移植术后早期合并ARDS患者免疫抑制剂血药浓度、大剂量免疫抑制剂冲击治疗对ARDS氧合状态及病死率的影响、ARDS患者细胞免疫状态和死亡原因。结果 ARDS患者术后早期免疫抑制剂血药浓度偏低。应用大剂量免疫抑制剂冲击治疗可以改善ARDS患者氧合和肺顺应性 ,延长生存时间 ,但不降低病死率。死亡患者严重感染和NK细胞降低。结论 免疫抑制剂通过抑制细胞因子减轻肺损伤 ,但未减低病死率。

Objective To observe the effect of immuno suppressive agents in liver transplantation recipients with acute respiratory distress syndrome(ARDS).Methods Seventeen ARDS patients that received immunosuppressive agents were admitted to this study.The plasma concentration of immunosuppressive agent,PaO 2/FiO 2,blood T cells,mortality were analyzed.Results ARDS patients had lower concentration of immunosuppressive agent.With high doses of corticosteroid and/or OKT3, PaO/FiO 2 could be improved,but there was no difference in mortality.Conclusion Immunosuppressive agents can efficiently decrease cytokines and cut down pulmonary damage,but the key way to decrease mortality of ARDS is preventing excessive immunodeficiency and infections. [