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目的:探讨黄芪注射液对急性呼吸窘迫综合征(ARDS)患者肺血管通透性的影响及对临床治疗效果。方法:纳入2014年1月至2014年10月间入住贵州省人民医院ICU的需机械通气的ARDS患者共100例,随机、双盲分为治疗组与对照组各50例,其中治疗组在相同的基础治疗外给予每日黄芪注射液20 ml加入100 ml生理盐水中静滴,对照组在同时间给予等量生理盐水静滴。两组患者在入ICU第1、3、5天时分别抽血检测血气分析、血TNF-α、IL-1水平,通过Picco监测EVLWI、PVPI水平,取肺泡灌洗液检测总蛋白含量,记录患者机械通气时间、住ICU时间、住院时间及90天死亡率。结果:两组患者入ICU时各项指标差异均无统计学意义。在3天与第5天时与对照组相比,治疗组氧合指数显著增加(P<0.05),血TNF-α、IL-1水平,EVLWI、PVPI水平,肺泡灌洗液白蛋白水平均显著降低(P<0.05),治疗组住ICU时间及住院时间均显著低于对照组(P<0.05)。结论:应用黄芪注射液可以降低ARDS患者肺血管通透性,该作用可能与其减轻炎症反应有关,并且可以改善患者临床预后。
Objective: To investigate the effect of astragalus injection on pulmonary vascular permeability in patients with acute respiratory distress syndrome (ARDS) and its clinical effect. Methods: A total of 100 cases of ARDS patients admitted to ICU of Guizhou Provincial People’s Hospital from January 2014 to October 2014 were randomly divided into treatment group (50 cases) and control group (50 cases) The basic treatment of external administration of Astragalus injection 20 ml added 100 ml of normal saline intravenously, the control group at the same time given the same amount of saline intravenous infusion. The levels of blood gas, blood TNF-α and IL-1 in blood were detected by blood sampling on the 1st, 3rd and 5th day of ICU. The EVLWI and PVPI levels were monitored by Picco. Total protein was detected by alveolar lavage. Mechanical ventilation, ICU stay, hospital stay and 90-day mortality. Results: There was no significant difference in each index between the two groups when they entered the ICU. Compared with the control group, the oxygenation index of the treatment group increased significantly (P <0.05) on day 3 and day 5, and the levels of TNF-α, IL-1, EVLWI and PVPI and albumin in bronchoalveolar lavage fluid significantly increased (P <0.05). The ICU time and hospital stay in the treatment group were significantly lower than those in the control group (P <0.05). Conclusion: Astragalus injection can reduce pulmonary vascular permeability in patients with ARDS, the effect may be related to its reduction of inflammatory response, and can improve the clinical prognosis of patients.