老年急性呼吸窘迫综合征患者应用甲泼尼龙、654-2联合治疗的疗效分析

目的探讨应用甲泼尼龙、654-2联合治疗对老年急性呼吸窘迫综合征患者的临床治疗效果.方法收集我院2014年6月至2015年6月入院的100例急性呼吸窘迫综合征老年患者随机分为两组,对照组患者给予甲泼尼龙治疗,实验组患者则加用654-2,比较两组患者近期总体治疗效果、治疗前后患者呼吸指标、血气学指标与炎症因子水平与死亡率.结果 实验组患者治疗总有效率明显高于对照组(92％vs.78％),差异有统计学意义(x2=3.843,P＜0.05).两组患者治疗后RR、PaC02、TNF-α与IL-6水平均显著低于治疗前,SpO2、PaO2与IL-10水平均显著高于治疗前,差异有统计学意义(P＜0.01);实验组患者治疗后RR、PaCO2、TNF-α与IL-6水平显著低于对照组,SpO2、PaO2与IL-10水平显著高于对照组,差异有统计学意义(P＜0.01).实验组患者治疗后2个月与4个月死亡率明显低于对照组(6％vs.18％,16％ vs.32％),差异有统计学意义(P＜0.05).结论 甲泼尼龙、654-2联合治疗对老年急性呼吸窘迫综合征患者的近期治疗效果显著,但在治疗6个月后无法降低死亡率,具有借鉴性.

Efficacy analysis of methylprednisolone combined with 654-2 in the treatment of elderly patients with acute respiratory distress syndrome

Objective To investigate the clinical efficacy ofmethylprednisolone combined with 654-2 in the treatment of elderly patients with acute respiratory distress syndrome (ARDS).Methods 100 elderly patients with ARDS admitted in our hospital from June 2014 to June 2015 were randomly divided into two groups.Control group was treated with methylprednisolone,and experimental group was given 654-2 on the basis of methylprednisolone treatment.The recent overall treatment effect,respiratroy indices,blood gas indices,inflammatory cytokines levels before and after treatment,and the mortality rate of two groups were compared.Results The overall treatment effective rate of experimental group was significantly higher than that of control group (92％ vs.78％),with statistically significant difference (x 2=3.843,P＜0.05).After treatment,the levels of RR,PaCO2,TNF-α,and IL-6 of experimental group were significantly lower than those of control group,the levels of SpO2,PaO2,and IL-10 were significantly higher than those of control group,with statistically significant differences (P＜0.01).The mortality rate after 2,4 months of experimental group were significantly lower than those of control group (6％ vs.18％,16％ vs.32％),with statistically significant differences (P＜0.05).Conclusion The recent curative effect of methylprednisolone combined with 654-2 in the treatment of elderly patients with ARDS is obvious,but the mortality rate could not be decreased 6 months after treatment,this analysis is of reference.