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脓毒性休克病人补体水平下降,但其机理尚不清楚。补体水平还可能同预后有关。类固醇对休克的有益作用可能与它能抑制补体系统激活及粒细胞聚集活动有关。本研究拟对上述问题进行探索。研究对象为美国迈阿密大学附属医院收治入ICU的脓毒性休克患者,其诊断标准如下:收缩压低于90mmHg,如有高血压史则收缩压比原先水平低50mmHg;有脏器灌注减少征象如:神志改变和/或少尿(<20ml/h):静脉滴注0.9％NaCl 500ml以上,仍持续处于低血压状态;血培养阳性或存在明确的感染源。病人随机分为三组,第一组静脉用甲基强的松龙30mg/kg,第二组用地塞米松6mg/kg,第三组为对照。用药前,采血测C_3、C_4和B因子,用药后1.5及24小时
The level of complement in patients with septic shock decreased, but the mechanism is not clear. Complement levels may also be related to the prognosis. The beneficial effects of steroids on shock may be related to its ability to inhibit complement system activation and granulocyte aggregation. This study intends to explore the above issues. The study was performed in septic shock patients admitted to the ICU at the University of Miami Affiliated Hospital of the United States. The diagnostic criteria are as follows: systolic blood pressure less than 90mmHg, systolic blood pressure 50mmHg lower than the original level in the case of history of hypertension; Change and / or oliguria (<20ml / h): Infusions above 500ml 0.9% NaCl intravenously, still in hypotensive state; positive blood cultures or a clear source of infection. Patients were randomly divided into three groups, the first group intravenous methylprednisolone 30mg / kg, the second group with dexamethasone 6mg / kg, the third group as a control. Before medication, blood tests C_3, C_4 and B factor, 1.5 and 24 hours after treatment