高容量血液滤过对多器官功能障碍综合征患者呼吸力学和血流动力学的影响

目的 探讨高容量血液滤过对多器官功能障碍综合征(MODS)患者呼吸力学和血流动力学的影响.方法 选择各种病因的MODS患者41例,按照信封法随机分为高容量血液滤过(HVHF)组21例和连续性静脉-静脉血液滤过(CVVH)组20例.观察两组治疗前及治疗24 h气道峰压(Ppeak)、肺动态顺应性(Cdyn)、心排血量(CO)、外周循环阻力(SVR)、肺循环阻力(PVR)和血气分析.结果 HVHF组治疗24 h,Ppeak、Cdyn、CO、PVR、SVR、氧合指数分别为(31.32±2.23)cm H2O(1 cm H2O=0.098 kPa)、(26.18±3.54)ml/cm H2O、(6.18±0.91)L/min、(194.95±11.51)dyn·s·cm-5、(1071.55±66.50)dyn·s·cm-5、(220.41±21.41)mm Hg(1 mm Hg=0.133 kPa),与治疗前的(42.00±3.34)cm H2O、(17.91±4.31)ml/cm H2O、(8.68±1.17)L/min、(267.27±16.29)dyn·s·cm-5、(805.32±18.82)dyn·s·cm-5、(119.41±17.10)mm Hg比较,差异均有统计学意义(P＜0.01),且与CVVH组治疗24 h比较差异亦有统计学意义(P＜0.01).结论 HVHF可明显改善MODS患者的呼吸力学和血流动力学指标.

Abstract：

Objective To investigate the effect of continuous high volume hemofiltration (HVHF)on respiratory mechanics and hemodynamics in multiple organ dysfunction syndrome (MODS). MethodsForty-one adult patients with MODS who received mechanical ventilation were divided into HVHF group(21 cases) and continuous vein-vein hemofiltration (CVVH) group (20 cases) by envelople. The peak airway pressure (Ppeak), dynamic pulmonary compliance(Cdyn), cardiac output(CO ), systemic vascular resistance(SVR), pulmonary vascular resistance (PVR) and blood gas analysis before treatment and 24 hours after treatment were measured. Results Twenty-four hours after treatment, the levels of Ppeak, Cdyn, CO, PVR,SVR and oxygenation index were (31.32 ±2.23) cm H2O (1 cm H2O =0.098 kPa), (26.18 ±3.54)(220.41 ±21.41) mm Hg (1 mm Hg =0.133 kPa) respectively in HVHF group,significantly higher than those before treatment [(42.00 ±3.34) cm H2O, (17.91 ±4.31) ml/cm H2O, (8.68 ±1.17) L/min,(267.27 ± 16.29) dyn·s·cm-5, (805.32 ± 18.82)dyn ·s·cm-5, ( 119.41 ± 17.10) mm Hg] (P ＜ 0.01 ),as well as higher than those in CVVH group after 24 hours' treatment (P ＜ 0.01 ). Conclusion HVHF shows significant beneficial effects on respiratory mechanics and hemodynamics of MODS.     

不同氧疗技术对急性氮气窒息大鼠治疗效果的评价

目的 评价不同氧疗技术对急性氮气窒息大鼠的治疗效果,以探讨更加适合急性氮气窒息患者的现场氧疗技术.方法 健康成年雄性Wistar大鼠60只,随机分成对照组、单纯染毒组、33%浓度氧吸氧组、50%浓度氧吸氧组和高压氧舱吸氧组,每组12只.将氮气与空气混合成为96%氮气浓度的气体充入染毒罐,染毒组大鼠在染毒罐中静式吸入此混合气体1 h.单纯染毒组大鼠于染毒后吸入常压空气1 h;高压氧治疗组将大鼠置于高压氧舱中,纯氧洗舱并进行高压氧(压力为0.2 MPa,氧浓度>90%)吸氧治疗1 h;其他2个染毒组大鼠分别置于33%氧浓度和50%氧浓度的氧疗罐中,吸氧1 h.比较对照组、单纯染毒组和各吸氧治疗组大鼠的行为学表现、动脉血氧分压(PO2)、二氧化碳分压(PCO2)和血氧饱和度(SPO2)、肝肾功能指标和心肌酶的变化情况.结果 各组大鼠在染毒后出现先兴奋后抑制的表现,氧疗后意识得到恢复.单纯染毒组大鼠PO2[(79.67±9.12)mm Hg]和SPO2[(94.92±2.78)mm Hg]明显低于对照组,差异有统计学意义(P<0.01);33%氧浓度组、50%氧浓度组、高压氧疗组大鼠PO2[分别为(94.75±7.24)、(94.92±8.98)、(104.58±7.12)mmHg]均较单纯染毒组明显增加,SPO2[分别为(97.17±0.83)、(96.92±1.16)、(97.42±0.67)mmHg]也有所升高,差异均有统计学意义(P<0.05);33%氧浓度组和50%氧浓度组之间的差异无统计学意义(P>0.05);高压氧组PO2较另外2个氧疗组增加,差异有统计学意义(P＜0.05);高压氧组PCO2[(51.42±6.60)mm Hg]较50%浓度氧组[(44.58±3.42)mm Hg]增高,其他各组间PCO2的差异无统计学意义(P＞0.05).单纯染毒组大鼠天冬氨酸转氨酶(AST)[(270.50±49.05)U/L]、丙氨酸转氨酶(ALT)[(122.67±55.44)U/L]、尿素氮(BUN)[(7.31±0.93)mmol/L]、肌酐(Cr)[(28.32±4.35)μmol/L以及肌酸激酶(CK)[(1808.42±582.05)U/L]和肌钙蛋白(CtnI)[(22.52±14.29)ng/ml]均高于对照组,差异有统计学意义(P<0.05);而乳酸脱氢酶(LDH)[(1286.58±484.80)U/L]和α-羟丁酸脱氢酶(HBDH)[(553.08±53.46)U/L]无明显变化.各种方式氧疗后以上各项指标有部分降低,而高压氧治疗组AST[(165.25±30.87)U/L]、HBDH[(350.83±103.00)U/L]和CTnI[(11.23±5.38)ng/ml]较33%浓度氧或50%浓度氧治疗组下降更为明显,差异有统计学意义(P＜0.05 ).结论 及时有效的氧疗能够明显提高急性氮气窒息大鼠动脉PO2和SPO2,并且可以改善肝功能和心肌损害.而高压氧的使用更能够明显提高对氮气窒息大鼠的治疗效果.

Abstract：

Objective To Evaluate the effects of different oxygen therapies on the rats with acute nitrogen asphyxia and to study the best oxygen therapic protocol for patients with acute nitrogen asphyxia on the spot. Methods Sixty healthy male Wistar rats were divided into 5 groups: control, exposure to nitrogen, 33% oxygen treatment, 50% oxygen treatment and hyperbaric oxygen treatment groups. The behavioral performance, arterial oxygen pressure (PO2), carbon dioxide partial pressure (PCO2) and oxygen saturation (SPO2), biochemical changes in liver and kidney function and myocardial enzymes in 5 groups were measured. Results The rats exposed to nitrogen firstly were excited then inactive symptoms, but consciousness was recovered after oxygen therapy. The PO2 and SPO2 in nitrogen exposure group were (79.67±9.12) and (94.92±2.78) mm Hg, respectively, which were significantly lower than those in control group (P<0.01). The PO2 and SPO2 of 3 oxygen treatment groups were (94.75±7.24), (94.92±8.98), (104.58±7.12)mm Hg and (97.17±0.83), (96.92±1.16), (97.42±0.67)mm Hg, respectively, which were significantly higher than those in nitrogen exposure group (P<0.05). The PO2 in hyperbaric oxygen treatment group was significantly higher than those in other 2 oxygen treatment groups (P<0.05). The SPO2 in hyperbaric oxygen treatment group was (51.42±6.60) mm Hg which was significantly higher than that [(44.58±3.42)mm Hg] in 50% oxygen treatment groups (P<0.05). AST [(270.50±49.05)U/L], ALT [(122.67±55.44)U/L], BUN [(7.31±0.93 )mmol/L], Cr[(28.32±4.35) (μmol/L], CK [(1808.42 ±582.05 )U/L] and CtnI [(22.52±14.29 )ng/ml] in nitrogen exposure group were significantly higher than those in control group (P<0.05). AST [(165.25 ±30.87 )U/L], HBDH [(350.83± 103.00)U/L] and Ctnl [(11.23±5.38 )ng/ml] in hyperbaric oxygen treatment group were significantly lower than those in other 2 oxygen treatment groups (P<0.05). Conclusion Timely and effective oxygen therapy can significantly increase arterial pressure of oxygen and oxygen saturation in the rats with acute nitrogen asphyxia, and can improve liver function and cardiac damage. The hyperbaric oxygen chamber can significantly increase the therapeutic effects on rats with acute nitrogen asphyxiation.     

辛伐他汀治疗煤工尘肺肺动脉高压患者的临床观察

目的 探讨辛伐他汀治疗煤工尘肺肺动脉高压的疗效.方法 选择煤工尘肺肺动脉高压患者96例,随机分为治疗组(48例)和对照组(48例).对照组口服华法林2.5mg,每天1次,共4个月;治疗组口服辛伐他汀20mg,每晚1次,共4个月.治疗前后进行6min步行试验及以超声心动图测肺动脉压力.结果 治疗组治疗后6 min步行距离为(258±26)m,与治疗前[(225±19)m]及对照组治疗后[(240±20)m]比较,差异均有统计学意义(P＜0.05,P＜0.01).治疗组治疗后肺动脉压力为(36±3)mm Hg,较治疗前[(41±9)mm Hg]及对照组治疗后[(39±5)mm Hg]明显降低,差异有统计学意义(P＜0.05).结论 辛伐他汀能改善煤工尘肺肺动脉高压,疗效确切.

Abstract：

Objective To observe simvastatin treatment of pulmonary hypertension in patients with coal workers pneumoconiosis (CWP). Methods 96 CWP patients with pulmonary hypertension were randomly divided into treatment and control groups. The control group was treated with 2.5 mg warfarin, once a day for four months; the treatment group was treated with 20 mg simvastatin, taken in evening, for 4 months. 6 min walking distance (6MWD) test and inspection pulmonary artery pressure were measured by echocardiography before and after treatment. Results In the treatment group, the 6MWD were (258±26)m after treatment and (225±19)m before treatment, respectively. Compared with control group, pulmonary artery pressure was (41±9)mm Hg in the treatment group before treatment, (36±3)mm Hg in the treatment group after treatment, and( 39±5 )mm Hg in control group, respectively, the diffrence was statistically significant(P＜0.05 ). Conclusions Simvastatin can improve pulmonary hypertension in coal workers pneumoconiosis, and shows a definite curative ffect.     

Analysis of the influencing factors of embryo quality and pregnancy outcomes in frozen-thawed embryo transfer cycle in polycystic ovary syndrome patients北大核心CSCD

Objective To explore the influencing factors of embryos quality during the cycle of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) and pregnancy outcomes of frozen-thawed embryo transfer (FET) in patients with polycystic ovary syndrome (PCOS). Methods A retrospective case-control study design was used to analyze patients who received IVF/ ICSI treatment at the Reproductive Medicine Center of Tianjin Central Obstetrics and Gynecology Hospital from January 2015 to December 2019, underwent whole embryo cryopreserved and performed the first FET. The 1233 cycles included were divided into control group (n=561) and PCOS group (n=672) according to PCOS diagnosis. The general clinical characteristics, laboratory-related indicators and pregnancy outcomes of patients between the two groups were compared, and the affecting factors of the late miscarriage rate were analyzed by multivariate logistic regression. Results 1) In terms of the general clinical characteristics between the two groups, the differences of duration of infertility [(3.95±2.01) years vs. (4.84±2.91) years, P=0.007], body mass index (BMI) [(21.96±2.52) kg/m2 vs. (23.96±3.50) kg/m2, P<0.001], basal luteinizing hormone [(4.71±2.38) mU/L vs. (8.18±5.40) mU/L, P<0.001], basal estradiol [(45.49±31.80) ng/L vs. (56.67±54.17) ng/L, P=0.032], basal testosterone [(42.80±13.45) ng/L vs. (53.45±38.67) ng/L, P=0.001], gonadortopin initial used dosage [(230.80±54.07) U vs. (192.11±53.79) U, P<0.001] were statistically significant. The endometrium preparation plan in the FET cycle, more PCOS group patients received hormone replacement treatment [64.1% (431/672) vs. 26.6% (149/561)], while more patients in control group received natural cycle transplantation [73.4% (412/561) vs. 35.9% (241/672)], and the differences were statistically significant (all P<0.001). 2) In terms of the laboratory results, the number of oocytes retrieved in PCOS group (23.36±9.53) was higher than that in control group (20.32±8.81, P=0.002). The number of high-quality embryos and the rate of high-quality embryos in PCOS group [2.94±3.13; 33.3% (2016/6048)] were lower than those in control group [4.17±3.65, P=0.034; 46.3% (2339/ 5049), P<0.001], and the differences were statistically significant. 3) In the pregnancy outcomes, the high-quality embryo transfer rate and the biochemical pregnancy rate in control group were higher than those in PCOS group [71.0% (743/1046) vs. 59.3% (761/1284), P<0.001; 7.3% (41/561) vs. 4.5% (30/672), P=0.033], and the late miscarriage rate in PCOS group [10.3% (43/418)] was higher than that in control group [4.3% (16/326), P=0.002]. 4) Logistic regression analysis was performed on the influencing factors of late miscarriage. After correcting the confounding factors, PCOS (OR=2.573, 95% CI=1.270-5.212, P=0.009) and maternal high BMI (OR=1.080, 95% CI=0.991-1.176, P=0.031) were the risk factors for late miscarriage. Conclusion The number of high-quality embryos and the rate of high-quality embryos in PCOS patients were lower than those in non-PCOS patients. PCOS and high BMI were risk factors for late miscarriage in patients. Improving endocrine disorders and weight control in PCOS patients before fertility treatment is of positive significance for improving the pregnancy outcome of patients. © 2022 Chinese Medical Journals Publishing House Co.Ltd. All rights reserved.     

高浓度二氧化氮致大鼠急性肺水肿模型的建立

目的 建立高浓度二氧化氮(NO2)染毒SD大鼠致急性肺水肿的模型.方法 将SD大鼠随机分为对照组(8只)和染毒组(30只),染毒组以(6747.47±215.24)mg/m3 NO2通过动式染毒柜染毒90 s后以净空气平衡换气30 min;对照组大鼠入染毒柜以净空气平衡30 min.染毒组分别在6、12、18、24 h拍摄大鼠胸片,各时间点取6只大鼠留取血样后处死,取肺组织做病理检查,进行肺湿/干系数测定.检测全血红细胞膜超氧化物歧化酶(SOD)活力和血浆中心钠素(ANP)浓度.结果 染毒组大鼠均在24 h内发生肺水肿,胸片显示,斑片云雾状阴影,12 h时加重,18 h时斑片影加深,遍及全肺,呈现"白肺"状,24 h后无明显恢复.HE染色显示,染毒组6 h肺泡间隙增大,泡内有少量嗜伊红液体渗出,12 h后肺泡融合,泡内嗜伊红液体增多,18 h后肺泡及组织中充满嗜伊红液体,至24 h时无恢复.染毒组6、12、18、24 h肺湿/干系数分别为5.60±0.20、6.89±0.25、8.03±0.47、7.81±0.45,与对照组(4.72±0.06)比较,差异均有统计学意义(P＜0.01);染毒组12、18、24 h肺湿/干系数与6 h相比,差异均有统计学意义(P＜0.01);染毒后18、24 h肺湿/干系数与12 h相比,差异有统计学意义(P＜0.01).与对照组比较,染毒组6、12、18、24 h红细胞膜SOD活力均明显降低,差异有统计学意义(P＜0.01).染毒组18、24 h血浆中ANP浓度分别为(136.66±35.37)、(134.10±60.41)ng/ml,明显高于对照组[(31.31±13.06)ng/ml]、染毒组6、12 h[分别为(34.71±13.42)、(47.98±7.86)ng/ml],差异均有统计学意义(P＜0.01).结论 高浓度NO2以动式染毒柜染毒SD大鼠复制急性肺水肿模型是可行的.

Abstract：

Objective To establish the rats model of acute pulmonary edema induced by inhalation of high concentrations of nitrogen dioxide (NO2). Methods 38 SD rats were divided into the experimental group ( n=30 ) and the control group ( n=8 ). 30 rats in the experimental group were exposed to (6747.47±2 5.24) mg/m3 NO2 in the exposure system. At the time point of 6, 12, 18, 24 h, chest X-ray examination was taken for the experimental group And at each time point, 6 rats were sacrificed after taking blood samples. After sacrificing,the lung of rats was taken for pathological examination and calculated lung wet/dry weight ratio. Erythrocyte superoxide dismutase (SOD) activity and plasma atrial natriuretic peptide (ANP) concentration of blood samples were detected. Results Acute pulmonary edema was successfully induced by exposure to NO2 in 30 rats within 24 hours. There were some cloudy shadows without clear edge on the chest X-ray. To the time point of 12 hours, shadows combined with each other, and to the time point of 18 hours, the whole lung became "white"on the X-ray. The situation stabilized but not improved at the time point of 24 hours. HE staining of the lung tissue showed that to the time point of 6 hours, the alveolar gap increased and small amount of eosinophilic liquid leaked into alveolar. To the time point of 12 hours, alveolar combined with each other and eosinophilic liquid increased in amount. To the time point of 18 hours, the whole alveolar was filled with eosinophilic liquid and the situation stabilized till the time point of 24 hours. Wet/dry weight ratio of the experimental group at each time point were 5.6±0.20、6.89±0.25、8.03±-0.47、7.81 ± 0.45. There was significant difference compared with the control group which was 4.72 ± 0.06 (P＜0.01). There was statistical difference between 12,18,24 h and 6 h time points (P＜0.01). Moreover, statistical difference was observed between 18,24 h and 12 h time points for wet/dry weight ratio (P＜0.01). The erythrocvte SOD activity reduced significantly. Compared with the control group, there was a statistical difference (P＜0.01) at each time point. After exposure of 18 and 24hours, plasma A NP concentration ( 136.66± 35.37) and ( 134.10±60.41 ) ng/ml respectively, which were higher than (31.31 ± 13.06 ) ng/ml of control group and ( 34.71 ± 13.42 ) ng/ml of 6 hours time point and (47.98 ± 7.86 )ng/ml. The differences were significant (P＜0.01),Conclusion High concentrations of NO2 can induce acute pulmonary edema model successfully in SD rats.     

ω-3脂肪酸对肝部分切除术后患者炎症反应和免疫功能的影响

目的 探讨ω-3脂肪酸对肝部分切除术后患者炎症反应和免疫功能的影响.方法 肝部分切除患者82例参加本研究,所有患者按随机数表法随机分为两组,术后给予等热量、等氮肠外营养治疗.对照组单纯使用中长链脂肪乳,研究组使用中长链脂肪乳联合ω-3脂肪酸.分别于术前、术后第1、3、7天抽取空腹静脉血,检测肝功能(总蛋白、白蛋白、前白蛋白、谷丙转氨酶、谷草转氨酶)、凝血功能(国际标准化比值)、免疫球蛋白(IgA、IgG、IgM)、CD3、CD4/CD8及外周血白细胞计数等.结果 术后第7天研究组患者血清总蛋白(61.40±5.12)g/L显著高于对照组(58.54±5.53)g/L(P=0.018),研究组谷草转氨酶(32.37±11.92)U/L显著低于对照组(42.50±29.97)U/L(JP=0.048),研究组IgA(2.67±1.01)g/L显著高于对照组(2.15±0.77)g/L(P=0.027),研究组IL-1β(7.88±6.45)pg/ml显著低于对照组(12.98±11.07)pg/ml(P=0.034),研究组IL-2(24.98±20.38)pg/ml显著低于对照组(43.09±20.74)pg/ml(P:0.002).两组患者术后第7天外周血白细胞及凝血功能指标差异无统计学意义.结论 ω-3脂肪酸有助于改善肝部分切除术后患者免疫功能及肝功能,降低炎症反应.

Abstract：

Objective To investigate the effects of ω-3 fatty acids (FA) on inflammatory reaction and immunologic function of patients after hepatectomy. Methods Totally 82 patients were randomized into control group and ω-3 FA group. Both groups received parenteral nutrition (PN) with equal nitrogen and calories. Patients in the control group received medium and long-chain lipid emulsion, and those in the ω-3 FA group received ω-3 FA combined with medium and long-chain lipid emulsion. Liver function test (serum total protein, prealbumin, albumin ,aspartate aminotransferase, alanine aminotransferase) , blood coagulation function (international normalized ratio) , immune globubin (IgA, IgG, and IgM) , CD3 and CD4/CD8 were measured on the first, third, and seventh post-operative day. Results Serum total protein in the ω-3 FA group [(61. 40 ±5. 12) g/L] was significantly higher than in the control group [(58. 54 ± 5. 53 ) g/L] (P = 0. 018 ) . Aspartate aminotransferase in the ω-3 FA group [(32. 37 ± 11. 92) U/L] was significantly lower than in the control group [(42. 50 ± 29. 97) U/L] (P = 0. 048). IgA in the ω-3 FA group [(2. 67 ± 1. 01) g/L] was significantly higher than in the control group [(2. 15 ±0.77) g/L] (P=0.027). IL-1β in the ω-3 FA group [(7.88 ±6.45) pg/ml] was significantly lower than in the control group [(12. 98 ± 11. 07) pg/ml] (P = 0.034). IL-2 in the ω-3 FA group [(24.98±20.38) pg/ml] was significantly lower than the control group [(43. 09 ± 20. 74) pg/ml] (P = 0.002). The white blood cell counts and coagulation function were not significantly different between two groups. Conclusion Total PN containing ω-3 FA can effectively improve immunologic function and liver function of patients after hepatectomy.     

过氯酸铵对大鼠甲状腺功能及其球蛋白和过氧化物酶mRNA表达的影响

目的 研究过氯酸铵(AP)对大鼠甲状腺功能及甲状腺球蛋白(Tg)、甲状腺过氧化物酶(TPO)基因mRNA表达的影响.方法 将雄性SD大鼠30只随机分为:正常对照组、低碘组(含碘量:50μg/kg)、AP染毒低(130 mg/kg)、中(260 mg/kg)、高剂量组(520 mg/kg)及AP+高碘组[AP:520 mg/kg,高碘饮水(10 mg/L)],每组5只.经口染毒90 d后处死,放射免疫法测定血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)及促甲状腺激素(TSH)的水平;荧光定量PCR法测定甲状腺球蛋白(Tg)、甲状腺过氧化物酶(TPO)基因mRNA表达水平.结果 AP中剂量和AP高剂量组FT4水平[(9.540±1.327)fmol/ml,(6.509±1.949)fmol/ml)明显低于正常对照组[(13.505±1.276)fmol/ml],差异有统计学意义(P＜0.05,P＜0.01).AP高剂量组的TSH水平[(1.227±0.295)mIU/L]明显高于正常对照组[(0.545±0.282)mIU/L],差异有统计学意义(P＜0.05);各AP剂量组Tg的mRNA表达相对值均明显低于正常对照组,差异有统计学意义(P＜0.01),AP高剂量组TPO基因mRNA表达相对值明显低于正常对照组,差异有统计学意义(P＜0.05).结论 AP可降低大鼠FT3、FT4水平,引起TSH反馈性增高,并明显抑制Tg和TPO基因mRNA的表达;而高碘可以在一定程度上拮抗AP对大鼠甲状腺的毒作用.

Abstract：

Objective To investigate the effects of ammonium perchlorate (AP) on thyroid functions and mRNA expression levels of thyroglobulin(Tg) and thyroperoxidase (TPO) genes of rats. Methods Thirty SD male rats were randomly divided into six groups: control group, iodine-deficient group, low dose AP group ( 130 mg/kg), moderate dose AP group (260 mg/kg), high dose AP group (520 mg/kg) and high iodinecombined group. After the rats were exposed orally for 90 days, serum free-thyroxine (FT4), freetriiodothyronine (FT3) and thyroid stimulating hormone (TSH) were measured using radioimmunoassays.mRNA expression levels of thyroglobulin (Tg) and thyroperoxidase (TPO) genes were detected by real-time quantitative PCR. Results Serum FT4 levels in moderate dose AP group and high dose AP group were [(9.540±1.327) fmol/ml] and [(6.509±1.949) fmol/ml] respectively, which were significantly lower than that [ (13.505 ±1.276 ) fmol/ml] in control group (P＜0.05 or P＜0.01). Serum TSH level in high dose AP group was [(1.227±0.295) mIU/L], which was significantly higher than that [(0.545±0.282) mIU/L] in control group (P＜0.05). The mRNA expression levels of thyroglobulin (Tg)gene in all groups exposed to AP were significantly lower than that in control group (P＜0.01). The mRNA expression level of thyroperoxidase (TPO)gene in high dose AP group was significantly higher than that in control group (P＜0.05). Conclusion AP can reduce the serum FT3 and FT4levels of rats, increase the serum TSH level of rats and decrease obviously the mRNA expression levels of Tg and TPO genes. In addition, high iodine can reduce the toxic effects of AP on thyroid gland of rats to some extent.     

冠心病患者血清前白蛋白及胆红素的临床意义

目的 探讨冠心病患者血清前白蛋白(PAB)和胆红素水平变化及其临床意义.方法 选取住院冠心病患者234例(冠心病组),其中稳定型心绞痛(SAP)80例,不稳定型心绞痛(UAP)84例,急性心肌梗死(AMI)70例;另选取同期住院的阵发性室上性心动过速患者77例作为对照组,分别测定血清PAB和胆红素水平并进行对比分析.结果 冠心病组血清总胆红素(TBIL)、直接胆红素(DBIL)及间接胆红素(IBIL)水平分别为(11.8±6.1)、(4.8±1.0)和(7.7±2.7)μmol/L,均显著低于对照组[分别为(14.6±5.6)、(6.2±1.3)和(9.5±6.1)μmol/L](P＜0.05).在冠心病组中,TBIL、DBIL、IBIL水平从SAP、UAP到AMI逐渐降低,但差异无统计学意义(P＞0.05).冠心病组血清PAB水平显著低于对照组[(205.55±5.68)mg/L比(229.78±9.62)mg/L](P＜0.05),在冠心病组中,SAP、UAP、AMI患者血清PAB水平分别为(215.73±7.98)、(214.12±3.79)和(195.75±7.07)mg/L,随病情逐渐加重,血清PAB水平逐渐降低,但差异无统计学意义(P＞0.05).结论 血清PAB和胆红素水平与冠心病患者的发生及其严重程度有关,在一定程度上可作为临床监测冠心病发病及严重程度的重要生化指标.

Abstract：

Objective To investigate the changes and clinical significance of serum prealbumin (PAB) and bilirubin in patients with coronary heart disease (CHD). Methods The levels of serum PAB and bilirubin were measured respectively in 234 patients with CHD (CHD group) and 77 patients with paroxysmal supraventricular tachycardia (PSVT, control group), and the former group was divided into stable angina pectoris (SAP) group with 80 patients,unstable angina pectoris (UAP) group with 84 patients and acute myocardial infarction (AMI) group with 70 patients,according to the chnical manifestation. Results The levels of total bilirubin (TBIL),direct bilirubin (DBIL) and indirect bilirubin (IBIL) in CHD group [ (11.8 ± 6.1 ), (4.8 ± 1.0) and (7.7 ± 2.7) μ mol/L] were significantly lower than those in control group [(14.6 ±5.6), (6.2 ±1.3) and (9.5 ±6.1)μmol/L] (P ＜0.05). The levels of TBIL, DBIL and IBIL decreased gradually from SAP group, UAP group to AMI group, but there was no significant difference among three groups (P ＞ 0.05 ). The levels of serum PAB in CHD group were also significantly lower than those in control group [(205.55 ±5.68) mg/L vs.(229.78 ± 9.62) mg/L] (P ＜ 0.05),and decreased gradually from SAP group,UAP group to AMI group [(215.73 ± 7.98), (214.12 ± 3.79) and (195.75 ± 7.07) mg/L],but there was no significant difference among three groups (P ＞ 0.05 ). Conclusion The levels of serum PAB and bilirubin are related to the severity of CHD, and can be used as important biochemical indicators in monitoring the attack and severity in patients with CHD.     

DSA下动脉取栓与传统的动脉取栓手术效果的比较研究

目的 比较DSA下动脉取栓手术与传统的动脉取栓手术的临床效果,评价DSA下动脉取栓的临床应用价值.方法 回顾分析2005年1月至2009年12月68例传统动脉取栓手术(A组)和72例DSA下动脉取栓手术(B组)的临床资料,比较两组手术情况(手术时间、出血量、术前术后踝肱指数变化、截肢率等).结果 B组手术时间[(76 ±17)min],明显少于A组手术时间[(95±22)min,t=5.74,P＜0.01];B组术中出血量[(83±35)ml]显著少于A组出血量[(102±58)ml,t=2.362,P＜0.05];B组手术前后踝肱比差值(0.32±0.08)与A组手术前后踝肱比差值(0.25±0.12)有明显改善(t=2.33,P＜0.05);A组有8例病人截肢,B组有2例病人发生截肢(u=2.06,P＜0.05);A组有2例病人死亡,B组有1例病人死亡(P＞0.05).结论 DSA下动脉取栓术中可以精确的判断动脉栓塞的位置,并能够进一步确诊动脉硬化闭塞、动脉内血栓形成、动脉瘤等复杂的病变,提高了取栓的成功率,减少手术创伤,降低截肢率,是治疗急性动脉栓塞安全、有效的方法.

Abstract：

Objective Compared with the effect of thromboembolectomy assisted with intraoperative digital subtraction angiography (DSA) and traditional method,evaluate the value of intraoperative DSA on surgical procedures for acute lower limb arterial embolism. Methods Sixeight cases of traditional thromboembolectomy to take on the operation (group A) and 72 cases under the DSA operation (group B)were analyzed during January 2005 to December 2009, Comparing two sets of operation (time, the amount of bleeding and the ankle brachial index changes before and after the surgery , amputations rate). Results The operation time of group B [(76 ±17) min] was less than that of group A [(95 ± 22) min, t =5. 736, P ＜ 0. 01] ; the amount of bleeding of group B [(83 ± 35 ) ml] was significantly less than group A [(102 ± 58 ) ml, t = 2. 362, P ＜ 0. 05]; The difference of ABI in group B after the operation than before (0. 32 ±0. 08) than that in group A(0. 25 ±0. 12) had remarkably improved ( t =2. 33, P ＜0. 05) ;there were 8 patient amputations in group A and 2 in group B ( u = 2. 06 , P＜ 0. 05 ); there were 2 patients died in group A and one in group B ( P ＞ 0.05 ). Conclusion Thromboembolectomy assisted with DSA can be accurate assessment of the arteries embolism position, elevate the success rate in the operation ,reduce the rate of amputation saws.     

支气管堵塞器与双腔气管导管在单肺通气中对呼吸力学和血气影响的比较

目的 比较支气管堵塞器(BB)与双腔气管导管(DLT)在单肺通气中对呼吸力学和血气的影响.方法 将36例择期行肺叶切除术和食管癌根治术患者按投硬币法随机分为BB组(17例)和DLT组(19例).BB组完成单腔管插管后在纤维支气管镜引导下置入BB,DLT组完成插管后用纤维支气管镜检查确定DLT位置.摆好体位后记录两组双肺通气和单肺通气的气道峰压(Pmax)与肺动态顺应性(CLayn),单肺通气20 min后采动脉血,行动脉血气分析:动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、动脉血氧饱和度(SaO2).结果 两组双肺通气时的Pmax和CLdyn比较差异无统计学意义(P＞0.05).单肺通气时BB组Pmax[(21.00 ±3.59)cm H2O,1 cm H2O=0.098 kPa]明显低于DLT组[(26.89 ±4.21)cm H2O](P＜0.05),CLdyn[(28.10 ±6.24)ml/cm H2O]明显高于DLT组[(24.00±7.13)ml/cm H2O](P＜0.05);两组单肺通气20min后PaO2、PaCO2、SaO2比较差异无统计学意义(P＞0.05).结论 使用BB行单肺通气对呼吸力学参数的影响较使用DLT小,具有很好的临床应用价值.

Abstract：

Objective To compare the influences between bronchial blocker (BB) and double lumen tube (DLT) in respiratory mechanics and blood gas in one lung ventilation. Methods Thirty-six patients undergoing pulmonary lobectomy or radical operation of esophageal carcinoma were randomized into group BB (17 cases) and group DLT (19 cases). In group BB,BB was intubated under the guidance of a fibreoptic bronchoscope after intubation of single lumen tube; while in group DLT, the position of the tube was confirmed using fibreoptic bronchoscopy after intubation. The peek airway pressure (Pmax) and pulmonary dynamic compliance (CLdyn) during double lung ventilation and one lung ventilation were recorded in recumbent position. Blood samples were taken from, radial artery 20 min after one lung ventilation for blood gas analysis,partial pressure of oxygen in artery(PaO2), partial pressure of carbon dioxide in artery(PaCO2), saturation of arterial blood oxygen (SaO2) were recorded. Results No significant difference was found in Pmax and CLdyn between two groups during double lung ventilation,but Pmax was significantly lower in group BB [(21.00 ± 3.59) cm H2O,1 cm H2O = 0.098 kPa] than that in group DLT [(26.89 ±4.21) cm H2O] (P＜0.05), and CLdyn was greater in group BB [(28.10 ±6.24) ml/cm H2O] than that in group DLT [(24.00±7.13) ml/cm H2O ] (P ＜ 0.05); there were no significant differences in PaO2, PaCO2, SaO2 betweentwo groups during one lung ventilation (P＞ 0.05). Conclusion The influence to respiratory mechanics in one lung ventilation is smaller using BB than using DLT, BB has blocker well applicable value in clinics.     

双水平气道正压通气在早产儿轻度呼吸窘迫综合征的应用及对早期肺功能的影响

目的 探讨双水平气道正压通气(BiPAP)治疗早产儿轻度呼吸窘迫综合征(RDS)的临床疗效及对患儿早期肺功能的影响,为BiPAP应用于早产儿轻度RDS的治疗提供临床参考。方法 选择2016年6月-2018年1月安徽医科大学第三附属医院新生儿重症监护室(NICU)收治的76例早产儿轻度RDS为观察对象,生后即予无创呼吸支持,随机分为BiPAP组(38例)与持续气道正压通气(CPAP)组(38例),比较两组无创模式治疗早产儿RDS的治疗效果及对早期肺功能的影响情况。结果 1)与CPAP组比较,BiPAP组气管插管率明显降低(5.26% vs.26.32%,P<0.05),但平均无创通气时间、平均氧依赖时间、肺泡表面活性物质(PS)的重复应用、各种并发症的发生率、死亡率及平均住院时间的差异均无统计学意义(P>0.05);2)早期潮气肺功能参数中,与CPAP组比较,BiPAP组呼吸频率明显降低[(42.98±4.26)次/min vs. (46.13±4.58)次/min]、潮气量明显升高[(6.50±1.29)ml/kg vs. (5.55±1.03)ml/kg]、每分通气量明显增加[(0.50±0.66)L/(min·kg) vs. (0.45±0.47)L/(min·kg)] (P<0.05),而达峰时间比、达峰容积比、呼气峰流速及75%、50%、25% 潮气量时呼气流速差异无统计学意义(P>0.05)。结论 与CPAP相比,BiPAP治疗早产儿轻度RDS更加安全有效,同时可提高肺的顺应性,改善患儿早期肺功能。     

职业接触1-溴丙烷对女工神经系统和血液及生化学的影响

目的 探讨1-溴丙烷(1-BP)对职业接触女工健康的影响.方法 对4个1-BP生严工厂进行职业卫生现场调查.按1:1比例选取年龄配对的接触组和对照组女工各71人.作业环境中1-BP的监测运用直读式检气管和个体采样器测定.对工人进行问卷调查、神经行为学组表测试、胫神经和腓神经电生理检查、振动觉检查、血常规、血生化和激素水平检查.结果 作业环境中1-BP的浓度为0～402.40 mg/m3(平均32.19 mg/m3),工人时间加权平均接触浓度(TWA-8 h)为0.35～535.19 mg/m3(平均14.08 mg/m3).与对照组相比,1-BP接触工人的运动神经传导速度[(44.8±8.7)m/s]和感觉神经传导速度[(45.5±4.9)m/s]下降,远端潜伏期延长[(7.5±2.1)ms],足趾振动觉降低[双足音叉振动延迟时间分别为(6.2±4.4)和(5.7±4.4)s],神经行为学POMS量表中愤怒情绪得分增高(21.0±5.5),紧张、疲劳、迷茫情绪得分降低(7.8±5.5、5.6±4.1、6.1±3.8),差异均有统计学意义(P＜0.05).与对照组比较,接触组白细胞[(5.6±2.17)×103/μl]、红细胞[(3.9±0.4)×106/μl]、血红蛋白[(121.1±14.5)g/L]和肌酸磷酸激酶[(82.0±27.5)IU/L均明显降低,差异有统计学意义(P＜0.05),血清总蛋白[(8.0±0.5)g/dl]、乳酸脱氢酶[(335.2±356.6)IU/L]、促甲状腺激素[(3.6±2.3)μIU/ml]和尿促卵泡素水平[(18.7±24.4)mIU/ml]明显上升,差异有统计学意义(P＜0.05).结论 1-BP接触可能影响外周神经和中枢神经系统,并引起血液及生化学指标的异常.     

麻黄碱与去氧肾上腺素联合不同麻醉剂对剖宫产产妇麻醉质量与血流动力学的影响

目的探讨麻黄碱与去氧肾上腺素联合不同麻醉剂对剖宫产产妇麻醉质量与血流动力学的影响。方法回顾性分析2015年5~12月河北省优抚医院收治的126例择期剖宫产产妇的临床资料,均行腰-硬联合麻醉,采用随机数字表法分为3组,每组42例,分别泵入盐酸麻黄碱、去氧腺上腺素和不泵升压药物。比较3组麻醉效果、血流动力学、血气指标、不良反应。结果 1麻醉效果:麻黄碱组和去氧肾上腺素组产妇感觉阻滞起效时间、达最高平面时间、持续时间,运动阻滞起效时间、最大阻滞时间、恢复时间比较,差异均无统计学意义(P0.05)。2血流动力学:麻醉2 min、5 min、8 min、切皮时、子宫切开时,麻黄碱组平均动脉压[(80.23±4.76、73.60±3.29、76.42±3.54、74.31±3.18、75.08±3.42)mm Hg]均低于去氧肾上腺素组[(84.36±4.48、77.21±4.13、81.35±4.68、83.09±4.51、85.13±4.24)mm Hg];心率[(103.25±7.13、101.46±6.24、93.28±5.16、99.31±6.04、98.16±5.73)次/min]快于去氧肾上腺素组[(90.36±5.21、87.42±5.09、79.06±4.63、81.23±4.80、80.35±4.32)次/min];左心排量高于去氧肾上腺素组;差异均有统计学意义(P0.05)。3血气指标:麻黄碱组脐动脉、脐静脉血的二氧化碳分压[(66.25±12.43、49.78±7.76)mm Hg]、乳酸浓度[(4.18±1.85、3.09±1.27)mmol/L]均高于去氧肾上腺素组[(57.34±7.18、45.63±4.93)mm Hg]、[(2.41±0.69、1.81±0.28)mmol/L],差异有统计学意义(P0.05);4不良反应:麻黄碱组术中低血压、高血压及术后恶心呕吐等不良反应发生率(14.29%、47.62%、19.05%)均高于去氧肾上腺素组(2.38%、9.52%、2.38%)(P0.05)。结论联合应用麻黄碱与去氧肾上腺素均能保证剖宫产术麻醉质量,但去氧肾上腺素更有利于产妇的血流动力学稳定。     

子宫内膜异位症患者血清雌二醇、肿瘤坏死因子-α和血管内皮生长因子检测的临床意义

目的 探讨子宫内膜异位症(EMS)患者血清雌二醇(E_2)、肿瘤坏死因子(TNF)-α和血管内皮生长因子(VEGF)的临床意义.方法 选择EMS患者59例(EMS组),检测患者术前24 h、术后7 d及术后6个月随访时的血清E_2、TNF-αVEGF,并与同期健康查体的育龄妇女60例(对照组)进行比较.结果 EMS组术前血清E2、TNF-α和VEGF[(216.5±59.7)ng/L、(30.4±17.5)μg/L、(250.7±88.7)ng/L]均明显高于对照组[(100.2±33.2)ng/L、(11.2±3.6)μg/L、(103.2±49.2)ng/L]及术后[(121.3±44.6)ng/L、(13.4±6.2)μg/L、(153.9±58.7)ng/L](P<0.01);而EMS组术后血清E_2、TNF-α和VEGF与对照组比较差异均无统计学意义(P>0.05). EMS组Ⅲ～Ⅳ期患者血清E_2、TNF-α和VEGF[(316.5±77.6)ng/L、(51.1±12.3)μg/L、(305.1±69.7)ng/L]均显著高于对照组和Ⅰ～Ⅱ期患者[(170.7±48.2)ng/L、(25.8±10.1)μg/L、(169.2±36.1)ng/L](P<0.05或<0.01);Ⅰ～Ⅱ期EMS患者血清E_2、TNF-α和VEGF高于对照组(P<0.05). EMS患者术后6个月随访时有9例复发,50例未复发.复发患者血清E_2、TNF-α和VEGF[(187.8±46.7)ng/L、(23.9±9.5)μg/L、(185.3±57.4)ng/L]显著高于对照组(P<0.01);未复发患者血清E_2、TNF-αVEGF[(112.7±30.3)ng/L、(13.2±4.7)μg/L、(116.4±30.3)ng/L]与对照组比较,差异无统计学意义(P>0.05).结论 血清E_2、TNF-α和VEGF可能在EMS的发生、发展中起重要作用.检测EMS患者血清E_2、TNF-α和VEGF对病情和预后判断均有重要的临床意义.     

先天性心脏病并重度肺动脉高压孕妇围手术期两种监测心指数方法的评估

目的 评价动脉波形分析心输出量法（APCO）及肺动脉导管法（PAC）监测先天性心脏病并重度肺动脉高压孕妇行剖宫产围手术期心指数（CI）的一致性.方法 选取择期行剖宫产术的先天性心脏病并重度肺动脉高压孕妇45例,术中均同时采用APCO及PAC监测.采取连续硬膜外麻醉,于硬膜外给药前即刻（T1）、硬膜外给药后5 min（T2）、硬膜外给药后10 min（T3）、胎儿娩出前即刻（T4）、胎儿娩出后2 min（T5）、胎儿娩出后5 min（T6）记录CI.APCO及PAC监测的CI（分别为A-CI和P-CI）进行Pearson相关性分析和一致性检验.结果 各时点P-CI均高于A-CI,差异有统计学意义（P＜0.05）;与T1时比较,T2～T4、T6时A-CI和P-CI差异均无统计学意义（P＞0.05）,T5时A-CI[（4.5±1.1） L/（min ·m2）比（4.2±0.8）L/（min ·m2）]和P-CI [（6.2±1.5） L/（min ·m2）比（5.4±1.2）L/（min＆#183;m2）]均升高,差异有统计学意义（P＜ 0.05）;T1～T6时两种方法监测的CI均呈正相关（r值分别为0.931,0.955,0.945,0.892,0.960,0.913;P＜ 0.05）.Bland-Atlman一致性分析结果显示两种监测方法的一致性较差.结论 APCO与PAC监测先天性心脏病并重度肺动脉高压孕妇剖宫产围手术期CI的一致性较差,但在监测CI变化趋势上是相同的.     

静滴地尔硫卓在急性冠状动脉综合征治疗中的临床效果分析

目的 探索地尔硫卓在急性冠状动脉综合征治疗中的临床应用价值.方法 选取2011年1月～2011年12月某科就诊的60例急性冠状动脉综合征患者,机械抽样随机将其中38例分为地尔硫卓组,采用常规治疗;余者22例分为对照组,常规治疗基础之上加用地尔硫卓.结果 治疗后,地尔硫卓组发作频率[(0.3±0.1)次]比对照组[(1.3±0.8)次]显著低(P＜0.05).地尔硫卓组SBP[(114.3±10.8) mmHg]、DBP[(72.3±6.4) mm Hg]、HR[(66.8±3.4)次/分]、心肌氧耗指数[8 445.4±85.2]、CRP[(11.8±2.6) mg/L]、NT-proBNP[(145.6±18.1)ng/L]及TnI [(0.27±0.11) μg/L]比对照组[(123.1±14.8) mm Hg]、[(80.5±7.1) mmHg]、[(73.6±6.3)次/分]、[9 989.7±88.5]、[(32.5±10.2) mg/L]、[(232.5±32.8) ng/L]及[(0.46±0.12)μg/L]显著低(P＜0.05).对照显示,两组患者不良反应情况差异无统计学意义(P＞0.05).结论 地尔硫卓应用于急性冠状动脉综合征的治疗,可提高疗效,但并未增加不良反应,较为安全,值得临床中推广应用.     

复合微量营养素补充剂对北京市成人血和尿营养素水平的影响

目的 探讨复合微量营养素补充剂对健康成人体内营养素水平的影响。方法 选择北京市152名推荐食谱问卷得分低于12分的健康成年人作为研究对象,采用随机数字表法分为安慰剂组和补充剂组,每组76名。两组分别服用安慰剂和复合微量营养素补充剂。8周后检测受试者血浆及尿液中营养素浓度的变化情况。并于研究第56天同时给两组受试者服用复合微量营养素补充剂,观察服药前和服药后2h血浆营养素水平变化。结果 安慰剂组有3例失访,失访率为5.7％。服用复合微量营养素补充剂8周后,补充剂组的血浆α-生育酚[(18.23±0.82)比(14.55±0.73)μmol/L]、β-胡萝卜素[（4.28±0.29）比（2.38±0.24）μmol/L]、维生素C[(42.65±2.11)比(27.49±1.76)μmol/L]、B6[(323.51±15.88)比(69.43±10.47) nmol/L]和B12浓度[(1005.27±23.00)比(796.85±35.57) pmol/L],尿维生素B1[(899.24±70.73)比(174.42±13.38) μg/g·Cr]和B2水平[(3227.68±330.04)比(259.10±33.33)μg/g·Cr],及红细胞叶酸水平[(720.09±21.33)比(633.17±28.75) nmol/L]均明显高于安慰剂组（P均=0.0000）,血浆γ-生育酚浓度明显低于安慰剂组[(2.18±0.13)比(2.87 ±0.26) μmol/L,P=0.0001]。服用复合微量营养素补充剂2h后,补充剂组的血浆维生素C水平明显高于安慰剂组[(54.53±2.43)比(23.02±1.77)mol/L,P=0.0000]。结论 服用复合微量营养素补充剂可改变健康成人体内的营养素水平,但其意义有待进一步研究探讨。     

糖皮质激素治疗二氧化氮致大鼠急性肺水肿实验初步研究

目的 探讨糖皮质激素对二氧化碳(NO2)所致大鼠急性肺水肿的治疗效果.方法 将SD大鼠随机分为空白对照组、染毒组及大、中、小剂量糖皮质激素治疗组,每组6只.空白对照组予净空气平衡30 min,染毒组及大、中、小剂量糖皮质激素治疗组在NO2染毒后分别给予生理盐水2.5 mg/kg和地塞米松6.0、3.0、1.0 mg/kg.测定大鼠肺湿干重比(W/D),用ELISA法测定血浆心房利尿钠肽(ANP)含量、全血超氧化物歧化酶(SOD)活力及血浆中白细胞介素-6(IL-6)、IL-10、肿瘤坏死因子-α(TNF-α)、γ-干扰素(IFN-γ)的含量.结果 与空白对照组比较,大、中、小剂量激素治疗组及染毒组大鼠肺W/D明显升高,差异有统计学意义(P<0.05);与染毒组比较,大、中、小剂量激素治疗组大鼠肺W/D明显降低,差异有统计学意义(P<0.05).与空白对照组比较,大、中、小剂量激素治疗组及染毒组大鼠全血中SOD活力明显降低,差异有统计学意义(P<0.05);与染毒组比较,大、中、小剂量激素治疗组全血中SOD活力无明显改变,差异无统计学意义(P>0.05).与空白对照组比较,染毒组大鼠血浆中ANP含量明显升高,差异有统计学意义(P<0.05);与染毒组比较,大、中、小剂量激素治疗组大鼠血浆中ANP含量明显降低,差异有统计学意义(P<0.05).与染毒组[(68.55±27.84)pg/ml]比较,大、中、小剂量激素治疗组大鼠血浆中TNFα含量[分别为(27.04±8.19)、(40.10±9.09)、(39.76±9.60)pg/ml]明显降低,差异有统计学意义(P<0.05).与染毒组[(29.29±9.31)pg/ml]比较,大、中剂量激素治疗组大鼠血浆中IL-6含量[分别为(15.97±6.18)、(19.69±5.52)pg/ml]降低,差异有统计学意义(P<0.05).与染毒组[(44.38±9.19)pg/ml]比较,大、中、小剂量激素治疗组大鼠血浆中IL-10含量[(23.24±5.14)、(27.78±8.17)、(33.29±10.42)pg/ml]降低,差异有统计学意义(P<0.05).与染毒组[(30.83±6.82)pg/ml]比较,大、中剂量激素治疗组大鼠血浆中IFN-γ含量[分别为(7.21±4.55)、(19.23±4.35)pg/ml]降低,差异有统计学意义(P<0.05).结论 大、中、小剂量糖皮质激素均具有改善肺泡壁和毛细血管的通透性及非特异性的抗炎作用,对肺水肿有明显的治疗作用,在降低炎性因子方面,以大、中剂量激素治疗组效果更为明显.