卡络磺钠氯化钠注射液对重症脑血管病合并神经源性肺水肿治疗效果初探

Primary investigation on clinical effect of carbazochrome sodium sulfonate and sodium chloride injection on neurogenic pulmonary edema in severe cerebrovascular disease patients

目的探讨卡络磺钠氯化钠注射液治疗重症脑血管病合并神经源性肺水肿(neurogenic pulmonary edema,NPE)的临床疗效。方法将40例重症脑血管病合并NPE的患者,采用数字表法随机均分为卡络磺钠+标准治疗组和标准治疗对照组,观察并比较两组患者治疗后的临床疗效、治疗前和治疗第2、4、8天时血流动力学指标及炎性反应指标的变化。结果卡络磺钠治疗组撤机时间、抗生素使用时间、重症监护室(intensive care unit,ICU)住院时间均短于对照组,病死率和多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)发生率低于对照组,差异有统计学意义(P<0.05)。治疗第4天和第8天时,治疗组患者血管外肺水指数(extravascular lung water index,EVLWI)低于对照组,差异有统计学意义(P<0.05);治疗第8天时,治疗组患者肺血管通透性指数(pulmonary vascular permeability index,PVPI)低于对照组,差异有统计学意义(P<0.05)。治疗前两组患者的C反应蛋白(C-reactive protein,CRP)、白细胞(white blood cell,WBC)、中性粒细胞百分比(neutrophil percent,NEUT%)比较,差异无统计学意义(P>0.05);治疗第2、4、8天时,治疗组患者的CRP、WBC、NEUT%低于对照组,差异均有统计学意义(P<0.05)。结论卡络磺钠应用于重症脑血管病合并NPE的患者效果显著,为临床治疗该类疾病提供了新的治疗策略。

Objective To observe the clinical effect of carbazochrome sodium sulfonate and sodium chloride injection on neurogenic pulmonary edema(NPE)in severe cerebrovascular disease patients.Methods Totally 40 patients of severe cerebrovascular disease complicated with NPE,in accordance with the random number table,were randomly divided into two groups and numbered according to the order of hospitalization.The treatment group was given carbazochrome sodium sulfonate injection and standard therapy.The control group was only given standard therapy.The clinical efficacy,hemodynamic index and inflammatory index before and after treatment(2 nd,4 th and 8 th day)in the two groups were compared.Results The offline period,duration of antibiotics,duration of intensive care unit(ICU)stay,mortality and incidence of multiple organ dysfunction syndrome(MODS)of the treatment group were significantly lower than those of the control group(P<0.05).The extravascular lung water index(EVLWI)after treatment(4 th and 8 th day)of the treatment group were significantly lower than those of the control group(P<0.05).The pulmonary vascular permeability index(PVPI)after treatment(8 th day)of the treatment group were significantly lower than those of the control group(P<0.05).There was no significant difference in C-reactive protein(CRP),white blood cell(WBC)and neutrophil percent(NEUT%)before treatment between the two groups(P>0.05).CRP,WBC and NEUT%after treatment(2 nd,4 th and 8 th day)of the treatment group were significantly lower than those of the control group(P<0.05).Conclusion The application of carbazochrome sodium sulfonate in the patients with severe cerebrovascular disease complicated with NPE is effective,which provides a new therapeutic strategy.