Shi Ji-yue, Li Jin-zhu, Wang Wen-ge, Yang Xiao-guang, Hou Bao-jun, Zhang Hong-lin, Peng Rui-qin, Zhang Ai-min
Department of Medicine, Affiliated Hospital of Hebei Engineering College, Handan 056029, Hebei, China.
Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2005 Jun;17(6):357-60.
To observe the effect of verapamil-procaine compound (V-P) on prevention and treatment of acute respiratory distress syndrome (ARDS) subsequent to high risk operation.
Altogether 150 cases of major operations with high risk of ARDS were enrolled for study. They were randomly divided into three groups. V-P group: 5% glucose 500 ml and procaine 1 250 mg and verapamil 10 mg; procaine group: 5% glucose 500 ml and procaine 1 250 mg; control group: only glucose was given. The injection speed of the three groups were the same, and it was kept at 0.5 ml x h(-1) x kg(-1). The dosages of verapamil and procaine in V-P group and procaine group were doubled when the diagnosis of acute lung injury (ALI) or ARDS was confirmed. UT4000F was used in monitoring (non-invasive) blood pressure (BP), electrocardiogram (ECG), pulse oxygen saturation (SpO(2)), respiratory rate, and temperature. Blood routine and arterial blood gases measurements were intermittently performed. Diagnosis of systemic inflammatory response syndrome (SIRS), ALI and ARDS was made respectively according to published diagnostic criteria. SIRS score and acute physiology and chronic health evaluation II (APACHEII) score were performed.
Eleven cases in V-P group, 26 in procaine group, and 42 in control group manifested symptoms and signs of SIRS. There were notable differences among groups (all P<0.01). Four patients in V-P group, 7 in procaine group, and 19 in control group were shown to develop ALI. Significant difference was found between control and V-P or procaine group (both P<0.01), but no significant difference was found between procaine group and V-P group. Twelve cases were complicated with ARDS in control group 2 weeks after the operation, and among them 5 died of multiple organ failure. There was significant difference between control group and V-P group or procaine group (both P<0.01). Two patients were complicated with acute renal failure in V-P group, 2 in procaine group, and 5 in control group.
The V-P can interrupt SIRS to develop ALI, then ARDS and multiple organ dysfunction syndrome(MODS), and thus prevents and cures ARDS.
观察维拉帕米 - 普鲁卡因复合物（V - P）对高危手术后急性呼吸窘迫综合征（ARDS）的防治作用。
选取150例有发生ARDS高危因素的大手术患者进行研究。将其随机分为三组。V - P组：5%葡萄糖500 ml加普鲁卡因1250 mg及维拉帕米10 mg；普鲁卡因组：5%葡萄糖500 ml加普鲁卡因1250 mg；对照组：仅给予葡萄糖。三组的注射速度相同，均保持在0.5 ml·h⁻¹·kg⁻¹。当确诊为急性肺损伤（ALI）或ARDS时，V - P组和普鲁卡因组中维拉帕米和普鲁卡因的剂量加倍。采用UT4000F监测无创血压（BP）、心电图（ECG）、脉搏血氧饱和度（SpO₂）、呼吸频率及体温。间断进行血常规及动脉血气测定。分别根据已发表的诊断标准诊断全身炎症反应综合征（SIRS）、ALI和ARDS。进行SIRS评分及急性生理与慢性健康状况评分II（APACHEII）。
V - P组有11例、普鲁卡因组有26例、对照组有42例出现SIRS的症状和体征。组间差异有统计学意义（均P<0.01）。V - P组有4例、普鲁卡因组有7例、对照组有19例发生ALI。对照组与V - P组或普鲁卡因组之间差异有统计学意义（均P<0.01），但普鲁卡因组与V - P组之间差异无统计学意义。对照组术后2周有12例并发ARDS，其中5例死于多器官功能衰竭。对照组与V - P组或普鲁卡因组之间差异有统计学意义（均P<0.01）。V - P组有2例并发急性肾衰竭，普鲁卡因组有2例，对照组有5例。
V - P可阻断SIRS向ALI、进而向ARDS及多器官功能障碍综合征（MODS）发展，从而防治ARDS。
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