高压氧联合支气管肺泡灌洗对重型颅脑损伤肺部感染患者临床疗效及血清s TREM-1、HMGB1、CRP/Alb水平的影响

Effect of Hyperbaric Oxygen Combined with Bronchoalveolar Lavage on the Clinical Efficacy and Serum Levels of s TREM-1,HMGB1,and CRP/Alb in Patients with Severe Craniocerebral Injury and Pulmonary Infection

目的:探讨高压氧(HBO)联合支气管肺泡灌洗对重型颅脑损伤肺部感染(PI)患者临床疗效及血清可溶性髓系细胞触发受体-1(s TREM-1)、高迁移率族蛋白B1(HMGB1)、C反应蛋白/白蛋白(CRP/Alb)水平的影响。方法:选取2019年9月-2022年9月安徽中医药大学附属六安医院收治的72例重型颅脑损伤PI患者为研究对象,按随机数字表法分为观察组和对照组,每组各36例。对照组采用支气管肺泡灌洗治疗,观察组采用HBO联合支气管肺泡灌洗治疗。收集两组临床资料,对比两组临床疗效、治疗前后临床体征[体温、动脉血氧分压(PaO2),血白细胞计数(WBC)]、临床肺部感染评分(CPIS)、全身炎症反应综合征修正(ASS)评分、格拉斯哥昏迷评分(GCS)、血清指标(s TREM-1、HMGB1、CRP/Alb)。结果:观察组治疗总有效率94.44%高于对照组的77.78%(P<0.05);治疗后观察组体温、WBC、CPIS评分、ASS评分低于对照组,PaO_(2)、GCS评分高于对照组(P<0.05);治疗后观察组血清s TREM-1、HMGB1、CRP/Alb水平低于对照组(P<0.05)。结论:HBO联合支气管肺泡灌洗治疗重型颅脑损伤PI能减轻炎症反应,降低PI程度,减轻临床体征,提高临床疗效。

Objective:To investigate the effect of hyperbaric oxygen(HBO)combined with bronchoalveolar lavage on the clinical efficacy and serum levels of soluble triggering receptor expressed on myeloid cell-1(s TREM-1),high mobil ity group protein B1(HMGB1)and C-reactive protein/albumin(CRP/Alb)in patients with severe craniocerebral injury and pulmonary infection(PI).Methods:72 patients with severe craniocerebral injury and PI admitted to Lu'an Hospital Affiliated to Anhui University of Traditional Chinese Medicine from September 2019 to September 2022 were selected as the study subjects.They were divided into observation group and control group according to random number table method,with 36 patients in each group.The control group was treated with bronchoalveolar lavage,while the observation group was treated with HBO combined with bronchoalveolar lavage.Collect the clinical data of the two groups,and compared the clinical efficacy,clinical signs[body temperature,arterial partial pressure of oxygen(PaO2),white blood cell count(WBC)],clinical pulmonary infection score(CPIS),adjusted score of systemic inflammatory response syndrome(ASS)score,glasgow coma score(GCS),serum indicators(s TREM-1,HMGB1,CRP/Alb)before and after treatment.Results:The total effective rate in the observation group was 94.44%higher than 77.78%in the control group(P<0.05);After treatment,the body temperature,WBC,CPIS score and ASS score of the observation group were lower than those of the control group,while PaO_(2)and GCS scores were higher than those of the control group(P<0.05);After treatment,the serum levels of s TREM-1,HMGB1,CRP/Alb in the observation group were lower than those in the control group(P<0.05).Conclusion:HBO combined with bronchoalveolar lavage in the treatment of severe craniocerebral injury and PI can reduce inflammatory reaction,reduce the degree of PI,reduce clinical signs and improve clinical efficacy.