右美托咪定对肺内源性ARDS患者氧合指数及外周血炎性因子的影响

Effects of Dexmedetomidine on oxygenation index and peripheral blood inflammatory factors in patients with ARDS caused by pulmonary factors

目的探索右美托咪定对肺内源性ARDS患者氧合指数(OI)及外周血炎性因子影响。方法选取2016年1月至2018年1月间收治于郑州大学第二附属医院ICU的肺内源性ARDS患者为研究对象。最终纳入76例受试者,右美组(P组)39例、丙泊酚组(C组)37例。两组患者插管后分别给予右美及丙泊酚维持Ramsay镇静评分3～5分。测量插管后(T0)、镇静6 h(T1)、12 h(T2)、24 h(T3)各时点OI、全程C反应蛋白(全程CRP)、降钙素原(PCT)。采用SPSS 23. 0统计软件进行数据分析。结果 (1)两组患者OI值时间与处理效应间存在交互作用(F=5. 722,P=0. 001),单独效应分析表明T2时点出现组间差异(t=2. 952,P=0. 004)。两组OI值整体呈下降趋势,但P组下降较缓;(2)两组全程CRP整体分析存在交互作用(F=10. 344,P=0. 000),单独效应分析表明T1时点出现组间差异(t=-2. 556,P=0. 013),两组全程CRP整体呈上升趋势,但P组上升较缓;(3)两组PCT整体分析均存在交互作用(F=22. 440,P=0. 000),单独效应分析表明T2时点各指标出现组间差异(t=-4. 561,P=0. 000),且两组各指标整体呈上升趋势,但P组上升较缓。结论右美托咪定可延缓肺内源性ARDS患者肺部氧合情况的恶化及外周血中炎性因子合成及释放。

Objective To explore the effects of dexmedetomidine on the oxygenation index (OI)and peripheral blood inflammatory factors in patients with pulmonary endogenous acute respiratory distress syndrome (ARDS).Methods Selected ICU patients with intrapulmonary ARDS as a research objeet from January 2016to January 2018in our hospital.A total of 76related cases were included and divided into dexmedetomidine group (P group )and propofol group (C group),with 39eases in P group and 37cases in C group.After intubation,patients in both groups were given either dexamethol or propofol to maintain Ramsay sedation score of 3-5.Arterial blood oxygenation index (0I),full range of CRP,PCT were measured after intubation (T0),sedation 6h (T1),12h (T2),24h (T3)in the two groups.SPSS 23.0statistical software was used for data analysis.Results (1)There was an interaction between the time of OI and the treatment effect in the two groups (F =5.722,P =0.001).The single effect analysis showed that there was a difference between the groups at T2 (t =2.952,P =0.004).(2)The OI values of the two groups showed a decreasing trend overall,but the P group decreased slowly.(2)There was an interaction between the whole CRP analysis of the two groups (F =10.344,P =0.000).The single effect analysis showed that there was a difference between groups at T1(t =-2.556,P =0.013).The overall CRP of both groups showed an upward trend,but the P group rose slowly.(3)There was an interaction between PCT in the two groups (F =22.440,P =0.000).The single effect analysis showed that there were differences between the two groups at the T2time point (t =-4.561,P =0.000),and the indicators of the two groups showed an overall upward trend,but the P group increased slowly.Conclusion Dexmedetomidine can delay the deterioration of pulmonary oxygenation and the synthesis and release of inflammatory factors in peripheral blood of patients with pulmonary endogenous ARDS.