摘要
目的:探讨小剂量糖皮质激素治疗感染性休克对乳酸的清除率及预后的影响。方法:选取我院2006年1月至2011年6月82例感染性休克患者,随机分为对照组40例及观察组42例,分别给予常规治疗和在常规治疗的基础上加用小剂量甲基强的松龙,比较两组乳酸清除率、APACHEH评分及预后。结果:两组间治疗前乳酸水平及APACHEⅡ评分无统计学差异(P>0.05);治疗后两组的乳酸水平均下降,与治疗前比较均有统计学差异(P<0.05);与对照组比较,治疗后观察组乳酸水平明显下降,差异有统计学意义(P<0.05)。两组间治疗前后APACHEⅡ评分变化差异无显著性(P>0.05)。观察组的死亡率(31.0%)显著低于对照组(57.5%)(P<0.05);其血乳酸清除率(64.4±12.9)%显著高于对照组(47.5±10.3)%(P<0.05)。两组ICU住院时间比较,观察组(13±4)d明显短于对照组(22±7)d(P<0.05)。结论:小剂量糖皮质激素治疗能改善感染性休克患者乳酸清除率及预后。
Objective To investigate the influence of a low dose of glucocorticosteroid treatment on the hydroxypropionic acid clearance rate and prognosis of patients with Refractory Septic Shock. Methods Eighty-two patients wit h refractory septic shock were enrolled in this study from January 2006 to June 2010, and they were randomly divided into 2 groups, including the control group （n = 40） receiving conventional therapy and the observational group （n = 42） receiving conventional therapy and a low dose of glucocortieosteroid treatment. Hydroxypropionie acid clearance rate, APACHEH grade and the prognosis of the patients were compared between these two groups at several different time points. Results No significant differences in the levels of hydroxypropionic acid and the APACHEH grade were shown between two groups before treatment （P 〉 0.05）. The hydroxypropionic acid level was obviously lower after therapy than that before therapy in both two groups （P 〈 0.05 ）. Compared with the control group, A lower level of hydroxypropionic acid was achieved in the observational group after therapy. There was no significant differences in APACHEH grade between these two groups before and after therapy. At the end of this study, compared with the control group, higher Hydroxypropionic acid clearance rate [（64.4±12.9）% vs. （47.5±10.3）%, P 〈 0.05] and lower mortality rate （31.0% vs. 57.5%, P 〈 0.05） were shown in the observational group. The ICU length of stay was also significantly shorter in the observational group than that in the control group [ （13 ± 4） days vs. （22 ±7） days, P 〈 0.05 ]. Conclusions A low dose of glucocorticosteroid treatment can improve the hydroxypropionic acid clearance rate and prognosis of patients with refractory septic shock.
出处
《实用医学杂志》
CAS
北大核心
2012年第18期3055-3057,共3页
The Journal of Practical Medicine
