甲泼尼龙短期治疗对肺挫伤炎症、抗凝因子和呼吸功能的影响

Effects of Methylprednisolone on Pulmonary Contusion Inflammation,Anticoagulant Factors and Respiratory Function in Short-term Treatment

目的观察甲泼尼龙短期冲击治疗肺挫伤的效果和安全性。方法选取2018年1月至2020年4月泰州市姜堰中医院ICU收治的76例肺挫伤患者作为研究对象,按随机数字表法分为观察组和对照组,各38例,对照组给予常规救治措施,观察组加用甲泼尼龙短期冲击治疗,观察疗效指标和药物不良反应。结果治疗3 d和7 d时,观察组血清白介素-6和肿瘤坏死因子-α水平及肺损伤Murray评分低于对照组(P<0.05),肺泡灌洗液中血栓调节蛋白和抗凝血酶Ⅲ、氧合指数高于对照组(P<0.05)。观察组的机械通气率、急性呼吸窘迫综合征(ARDS)率和死亡率低于对照组(P<0.05),两组不良反应率差异无统计学意义(P>0.05)。结论甲泼尼龙短期冲击治疗肺挫伤,能有效抑制炎症反应,提高肺泡内抗凝功能,降低ARDS发生率,改善疾病预后。

Objective To investigate the efficacy and safety of methylprednisolone in the treatment of pulmonary contusion.Methods Totally 76 patients with pulmonary contusion admitted to ICU in Taizhou Jiangyan Hospital of Traditional Chinese Medicine from January 2018 to April 2020 were selected and divided into observation group and control group by random number table method,38 patients in each group.The control group was given routine treatment,while the observation group was given short-term shock treatment with methylprednisolone,and the curative effect indexes and adverse drug reactions were observed.Results On 3 d and 7 d after treatment,serum interlukin-6 and tumor necrosis factor-αlevels and Murray scores in the observation group were lower than those in the control group,thrombomodulin in alveolar lavage fluid and antithrombinⅢ,oxygenation index were higher than the control group(P<0.05).The mechanical ventilation rate,ARDS rate and mortality rate in the observation group were lower than those in the control group(P<0.05),and there was no significant difference in adverse reaction rate between the two groups(P>0.05).Conclusion Methylprednisolone can effectively inhibit the inflammatory response,improve the anticoagulation function in alveoli,and reduce the incidence of ARDS,improve prognosis of the disease.