重组人生长激素对肺外源性ARDS患者预后、免疫功能及炎性介质的影响

目的探讨重组人生长激素对肺外源性呼吸窘迫综合征(ARDS)患者预后、肺功能及免疫功能的影响。方法选取84例ARDS患者,根据随机数字表将患者分为观察组(n=42)及对照组(n=42),对照组患者按照《ARDS诊治指南》行常规性治疗,观察组在对照组基础上应用重组人生长激素实施治疗,治疗时间为7d,记录2组患者临床治疗效果及治疗前后免疫功能改善情况。结果观察患者治疗后Murray急性肺损伤评分、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)低于对照组(P0.05),观察组机械通气时间、入住ICU时间短于对照组(P0.05),死亡率低于对照组(P0.05)。观察组患者治疗后肺活量(VC)、肺总量(TLC)、用力呼气肺活量(FVC)、用力呼气肺活量1秒量(FEV1)、用力呼气肺活量1秒率(FEV1/FVC)及一氧化碳弥散量(DLCO)等肺功能指标较对照组显著提高(P0.05)。观察组治疗后CD3~+、CD4~+、CD4~+/CD8~+水平显著高于对照组(P0.05)。观察组治疗后白细胞介素(IL)-6、IL-8、肿瘤细胞坏死因子-α(TNF-α)水平显著低于对照组(P0.05)。结论重组人生长激素能有效改善肺外源性ARDS患者肺功能及提高患者免疫功能,有利于患者预后。

Effect of recombinant human growth hormone on prognosis,immune function and inflammatory mediators in patients with pulmonary exogenous ARDS

Objective To investigate the effects of recombinant human growth hormone on prognosis,pulmonary function and immune function in the patients with pulmonary exogenous respiratory distress syndrome (ARDS).Methods Eighty-four cases of ARDS were selected and divided into the observation group (n=42) and control group (n=42) according to the random number table.The control group was treated with the routine therapy according to the ARDS Diagnosis and Treatment Guidelines,while on this basis the observation group used recombinant human growth hormone for conducting treatment.The treatment time lasted for 7 d.The clinical effects and improvement situation of immune function before and after treatment were recorded in the two groups.Results The Murray acute lung injury score,and acute physiology and chronic health status score (APACHE Ⅱ) after treatment in the observation group were lower than those in the control group (P<0.05).The mechanical ventilation time and ICU stay of observation group were shorter than those of the control group(P<0.05).The mortality rate of the observation group was lower than that of the control group(P<0.05).The levels of vital capacity (VC),total lung volume (TLC),forced expiratory vital capacity (FVC),forced expiratory volume of vital capacity (FEV1),forced expiratory vital capacity 1 second (FEV1/FVC) and carbon monoxide (DLCO) after treatment in the observation group were significantly higher than those in the control group (P<0.05).The levels of CD3+,CD4+ and CD4+/CD8+ after treatment in the observation group were higher than those in the control group (P<0.05).The levels of interleukin-6(IL-6),interleukin-8 (IL-8) and tumor necrosis factor-a (TNF-α) after treatment in the observation group were lower than those in the control group (P<0.05).Conclusion Recombinant human growth hormone can effectively improve the pulmonary function in the patients with pulmonary exogenous ARDS,improves the immune function and is conducive to the prognosis of patients.