依托咪酯对机械通气患者相对肾上腺皮质功能不全和死亡率的影响

Effect of etomidate on relative adrenal insufficiency and mortality in patients with mechanical ventilation

目的:研究依托咪酯对机械通气患者相对肾上腺皮质功能不全(RAI)和死亡率的影响。方法:将机械通气患者随机分成依托咪酯组和丙泊酚组,2组均在治疗原发病基础上给予机械通气和镇静治疗,依托咪酯组给予依托咪酯镇静,丙泊酚组给予丙泊酚镇静。比较两组RAI和死亡率的差异。结果:依托咪酯组RAI发生率(62.99%)和死亡率(38.98%)均显著高于丙泊酚组(分别为46.85%和27.95%),差异均有统计学意义(P<0.05);依托咪酯组RAI和死亡率的相对危险度分别为丙泊酚组的1.34倍和1.39倍;在调整年龄、性别和急性生理学及慢性健康状况评分后,依托咪酯组RAI和死亡率的相对危险度分别为丙泊酚组的1.26倍和1.30倍。结论:依托咪酯可增加机械通气患者RAI发生率和死亡率。

Objective： To explore the effect of etomidate on relative adrenal insufficiency（RAI） and mortality in patients with mechanical ventilation. Methods： The patients receiving mechanical ventilation were divided into etomidate group and propofol group who respectively received the treatment of etomidate and propofol. The difference of the rates of RAI and mortality were compared between the two groups. Results： The rates of RAI（62.99% vs. 46.85%） and mortality（38.98% vs. 27.95%） in the etomidate group were significantly higher than that in the propofol group（P〈0.05）; the relative risk degree of RAI and mortality in the etomidate group were 1.34 and 1.39 folds of the propofol group respectively. After adjusting the age, gender, and acute physiology and chronic health status score, the relative risk degrees of RAI and mortality in the etomidate group were respectively 1.26 and 1.30 folds of the propofol group. Conclusion： The etomidate increased the rates of RAI and mortality in patients with mechanical ventilation.