广西医学2011，Vol.33Issue(6)：653-656,4.
小剂量氢化可的松治疗脓毒症休克的临床研究
Effect of Low-dose Hydrocortisone in the Treating patients with Septic Shock
摘要
Abstract
Objective To study the effects of low-dose hydrocortisone on inflammatory response in the patients with septic shock. Methods Eighty patients with septic shock were randomly divided into treatment group and control group. Both groups were treated by routine therapy and treatment group by additional injection of low-dose hydrocortisone.The mean arterial pressure( MAP ), heart rate( HR ), cardiac index, PaO2/FiO2 were measured and recorded before ( baseline )and at 4 hours, 12 hours, 24 hours,48 hours and 72 hours after intervention. Plasma levels of TNF-a,IL-1β, IL-6, IL-10 were detected by enzyme-linked immunosorbent assay( ELISA )respectively before( baseline )and at 4 hours, 12 hours ,24 hours ,48 hours and 7 days after treatment. APACHE Ⅱ score and blood lactate acid level( BLA )were recorded before( baseline )and at 24 hours ,48 hours and 7 days after treatment. The incidence of 28-day mortality between the two groups was compared. Results The indexes between the two groups were no significant differences before treatment( P ＞ 0.05 ). TNF-a, IL-1β, IL-6 were significantly decreased compared with the baseline values before treatment( P ＜ 0.05 ), while there was no significant changes in the plasma levels of IL-10( P ＞ 0.05 ),APACHE Ⅱ scores were significantly decreased after treatment( P ＜ 0.05 ). The levels of TNF-a, IL-1β and IL-6 at 4 hours, 12 hours,24 hours,48 hours, and 7 days after treatment in treatment group were lower than those in control group at different time points( P ＜ 0.05 ), There was no significant difference in 28-day mortality between the two groups( P ＞ 0.05 ). Conclusion Low-dose hydrocortisone can inhibit inflammatory response in patients with septic shock, and provide a chance treating primary diseases in patients with septic shock.关键词
脓毒症/休克/皮质醇/氢化可的松Key words
Septic shock/ Hydrocortisone/ Cortisol/ Hydrocortisone分类
医药卫生引用本文复制引用
林勇军,熊滨,吕立文,王风,韩林,张静,陈解语,柳锋霖..小剂量氢化可的松治疗脓毒症休克的临床研究[J].广西医学,2011,33(6):653-656,4.基金项目
广西科学基金资助项目(0542064) （0542064）
