發(fā)布時間：2018-10-24 09:57

【摘要】：目的檢測患者血清IL-6和CRP水平,探討急性A型主動脈夾層并發(fā)肺損傷與炎性反應的相關性。方法選擇2007年1月至2016年2月醫(yī)院收治的急性A型主動脈夾層患者216例,其中,男120例,女96例,平均年齡52.1歲。所有患者都經(jīng)過心臟彩超等影像學檢查并確診,且在發(fā)病后立即住院,并治療1周以上。在平靜吸氧狀態(tài)下,患者術前氧合指數(shù)≤200定義為肺損傷陽性。本研究根據(jù)此次定義把患者分為肺損傷陽性組和肺損傷陰性組,其中216例患者陽性組72例,陰性組144例。216例患者住院后每隔4 h抽取動脈血進行計算氧合指數(shù)。同時抽取血標本,用于統(tǒng)一檢測C反應蛋白(CRP)、白介素6(IL-6)水平。評估患者血清CRP水平和IL-6水平與急性A型主動脈夾層并發(fā)肺損傷的關系。結果肺損傷陽性組與陽性組兩組患者分別在性別、年齡、吸煙喝酒、常見慢性病等方面的差異均無統(tǒng)計學意義(P0.05);術前實驗學檢查、心臟彩超等幾項檢查差異均無統(tǒng)計學意義(P0.05);比較兩組患者,肺損傷陽性組患者血清CRP峰值水平和IL-6峰值水平均顯著高于肺損傷陰性組患者,差異有統(tǒng)計學意義(P0.05);進一步研究肺損傷患者血清CRP、IL-6水平與氧合指數(shù)的關系,發(fā)現(xiàn)夾層發(fā)生后,患者的氧合指數(shù)逐漸下降,而血清C反應蛋白和白介素6水平均迅速上升,達到峰值水平,而后,隨著患者炎性反應減弱,氧合指數(shù)呈現(xiàn)上升的趨勢。結論炎性反應在急性A型主動脈夾層引發(fā)肺損傷中起關鍵作用,隨著患者患病時間的延長,患者血清C反應蛋白和白介素6水平與低氧血癥關系密切。積極在術前予以抗炎治療,可能會改善患者的氧合狀況。
[Abstract]:Objective to investigate the correlation between pulmonary injury and inflammatory response in acute type A aortic dissection by detecting serum IL-6 and CRP levels. Methods 216 patients with acute type A aortic dissection were selected from January 2007 to February 2016, including 120 males and 96 females, with an average age of 52.1 years. All patients were diagnosed by echocardiography and were admitted to hospital immediately after onset and treated for more than 1 week. The preoperative oxygenation index 鈮，

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