前列地尔对重症感染合并ARDS患者免疫、呼吸功能及不良反应分析

Effect of Alprostadil on Immune Function, Respiratory Function and Adverse Reactions in Patients with Severe Infection and ARDS

目的分析前列地尔对重症感染合并ARDS患者免疫、呼吸功能及不良反应。方法选择医院2018年1月-2020年1月收治的重症感染合并ARDS患者60例,使用随机数字法将其分成常规组与治疗组,每组30例。常规组患者接受常规治疗,治疗组患者接受前列地尔治疗。观察和比较两组患者的一般指标、免疫功能指标、呼吸功能指标和不良反应。结果治疗组患者机械通气时间、ICU住院时间、总住院时间少于常规组(P<0.05)。治疗前两组患者的免疫功能相近,CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)差异比较无统计学意义(P>0.05),治疗后CD4^(+)、CD4^(+)/CD8^(+)水平上升,CD8^(+)下降;治疗组患者治疗后CD4^(+)、CD4^(+)/CD8^(+)水平水平高于常规组(P<0.05),CD8^(+)低于常规组(P<0.05)。两组患者治疗3d的RR下降,OI、PaCO;升高;治疗组患者在治疗3d的RR水平低于常规组(P<0.05),OI、PaCO;水平高于常规组(P<0.05)。治疗组患者不良反应率高于常规组(P>0.05),差异比较无统计学意义。结论前列地尔治疗重症感染合并ARDS能促使患者免疫、呼吸功能改善,减少住院时间,且不增加不良反应,建议使用。

Objective To investigate the effect of alprostadil on immune function, respiratory function and adverse reactions in patients with severe infection and ARDS.Methods 60 patients with severe infection and ARDS in our hospital from January 2018 to January 2020 were enrolled, and divided into two groups by random number table methods, each with 30 cases.Routine group received routine treatment, while treatment group received alprostadil.Then the general indicators, immune function indicators, respiratory function indicators and adverse reaction rate were compared between groups.Results The mechanical ventilation time, ICU hospitalization time, and total hospitalization time of treatment group were shorter than those of routine group(P<0.05).CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)levels had no significant difference between groups before treatment(P>0.05),After treatment, there was an increase in levels of CD4^(+)and CD4^(+)/CD8^(+)(P<0.05),and a decrease in CD8^(+)level(P<0.05),moreover, both changes were more obvious in treatment group than in routine group(P<0.05).After treatment for 3 days, there was a decrease in RR level(P<0.05),and an increase in OI and PaCO;(P<0.05),and both changes were more significant in treatment group than in routine group(P<0.05).The adverse reaction rate of treatment group was higher than that of routine group, with no significant difference(P>0.05).Conclusion Alprostadil can effectively ameliorate the immune function and respiratory function, reduce the length of stay for patients with severe infection and ARDS,without increasing the adverse reaction rate, so it is worthy of recommendation.