血液净化对肺外型急性呼吸窘迫综合征肺血管外肺水及通透指数的影响

Effect of blood purification on extravascular lung water and permeability index in extrapulmonary acute respiratory distress syndrome

目的观察连续性血液净化（CBP）对重症肺外型急性呼吸窘迫综合征（ARDSexp）患者肺血管外肺水及通透指数的影响。方法15例确诊的重症ARDSexp患者行CBP治疗，记录治疗开始后反映肺血管外肺水的指标血管外肺水指数（EVLWI）、肺毛细血管通透指数（PVPI）及炎性指标水平的变化。结果与治疗前比较，治疗后EVLWI、PVPI有明显下降（P〈0．01），C反应蛋白、白细胞介素-6、降钙素原、系统性炎症反应综合征评分及急性生理和慢性健康状况Ⅱ评分有明显下降（P〈0．01）。结论CBP可改善重症ARDSexp患者肺血管外肺水及通透指数和全身炎性反应水平及预后。

Objective To observe the effects of continuous blood purification（CBP） on extravascular lung water and permeability index in patients with severe extrapulmonary acute respiratory distress syndrome （ARDSexp）. Methods Fifteen patients with severe ARDSexp were treated with CBP. The level of extravascular lung water index （EVLWI） and pulmonary vascular permeability index （PVPI） was measured before and after treatment,and at the same time the changes of inflammatory indicators were recorded. Results Compared with that before treatment,EVLWI and PVPI was decreased obviously after treatment （P 〈 0.01 ）, the level of C-reactive protein and interleukin 6 （IL-6）, calcitonin and systemic inflammatory response syndrome score and the acute physiology and chronic health Ⅱ score was significantly decreased （P 〈 0.01 ）. Conclusion CBP can improve the level of EVLWI, PVPI and inflammatory indicators and also the prognosis of severe ARDSexp.