早期给予糖皮质激素对急性呼吸窘迫综合征患者血乳酸及红细胞分布宽度的影响

Effect of early administration of glucocorticoid on blood lactic acid and red blood cell distribution width in patients with acute respiratory distress syndrome

目的探讨早期给予糖皮质激素对急性呼吸窘迫综合征患者血乳酸及红细胞分布宽度的影响。方法选取2018年5月至2020年7月来宾市中医医院收治的急性呼吸衰竭患者80例,按照随机数字表法分为两组,观察组与对照组,每组各40例,对照组实施经验治疗,观察组则建议早期应用糖皮质激素,比较两组行呼吸机治疗、在ICU监护治疗及总住院治疗时间,统计治疗前后两组血乳酸及红细胞分布宽度变化情况,并针对观察组患者氧合指数与乳酸及红细胞分布宽度进行相关性分析。结果观察组行有创呼吸机治疗、在重症监护室(ICU)监护治疗及总住院治疗时间均短于对照组,差异有统计学意义(P<0.05),观察组乳酸水平高于对照组,差异有统计学意义(P<0.05),红细胞分布宽度大于对照组,差异有统计学意义(P<0.05),观察组患者氧合指数与乳酸及红细胞分布宽度呈负相关,差异有统计学意义(P<0.05)。结论针对急性呼吸窘迫综合征患者,早期使用糖皮质激素治疗,可缩短患者使用呼吸机时间、进行重症监护时间及总住院时间,降低血乳酸及红细胞分布宽度水平,提高氧合指数,改善患者预后。

Objective To discuss the effect of the early administration of glucocorticoid on blood lactic acid(BLA)and red blood cell distribution width(RDW)in patients with acute respiratory distress syndrome(ARDS).Methods A total of 80 patients with acute respiratory failure admitted to Laibin Hospital of Traditional Chinese Medicine from May 2018 to July 2020 were selected.According to the method of random number,they were divided into the observation group and the control group,40 cases in each group.The control group was treated with empirical therapy,while the observation group was advised to administrate glucocorticoid at the early stage.The duration of ventilator treatment,the duration of Intensive Care Unit(ICU)monitoring and the total length of hospital stay were compared between the two groups.The changes of BLA and RDW in the two groups before and after treatment were counted.The correlation between oxygenation index(OI),BLA and RDW in the observation group was analyzed.Results The duration of invasive ventilator treatment,the duration of ICU monitoring and the total length of hospital stay were shorter in the observation group than those of the control group,with statistically significant differences(P<0.05).The level of BLA was higher in the observation group than that in the control group,with statistically significant difference(P<0.05).The RDW was higher in the observation group than that of the control group,with statistically significant difference(P<0.05).The OI of patients in the observation group was negatively correlated with BLA and RDW,with statistically significant difference(P<0.05).Conclusion The early administration of glucocorticoid can shorten the duration of ventilator treatment,the duration of ICU monitoring and the total length of hospital stay,reduce the levels of BLA and RDW,and improve the OI and the prognosis of patients with ARDS.