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气管内滴注全氟己烷通过减轻烟雾吸入性损伤患者的早期炎症因子来调节肺部免疫微环境:一项随机对照临床试验

Intratracheal Instillation of Perfluorohexane Modulates the Pulmonary Immune Microenvironment by Attenuating Early Inflammatory Factors in Patients With Smoke Inhalation Injury: A Randomized Controlled Clinical Trial.

作者信息

Ding Hui, Lv Qi, Wu Shiman, Hou Shike, Liu Ziquan, Landén Ning Xu, Tian Ping, Yu Mengyang, Sun Zhiguang, Fan Haojun

机构信息

From the *Institute of Disaster Medicine and Public Health, Affiliated Hospital of Logistic University of Chinese People's Armed Police Force (PAP), Tianjin, China; †Key laboratory of Emergency and Disaster Medicine in Chinese People's Liberation Army (PLA), Tianjin, China; and ‡Department of Medicine, Karolinska Institute, Stockholm, Sweden.

出版信息

J Burn Care Res. 2017 Jul/Aug;38(4):251-259. doi: 10.1097/BCR.0000000000000496.

Abstract

Smoke inhalation injury (SII) is associated with significant morbidity and mortality in burn patients, and effective treatments are lacking. Perfluorocarbons (PFCs) have a protective effect against acute lung injury. We aimed to assess the therapeutic effects of perfluorohexane on burn patients with SII. Patients with burns complicated by moderately severe SII were randomly divided into control (n = 11) and PFC groups (n = 12). The control group received conventional treatment (anti-infection, nutritional support, antishock measures, and supportive treatment). The PFC group received endotracheal perfluorohexane instillation in addition to conventional treatment. On admission and 3 days later, therapeutic effects were evaluated and inflammatory mediators in bronchoalveolar lavage fluid and plasma were analyzed. There was no significant difference between the control and PFC group on admission. After 3 days, perfluorohexane treatment significantly (P < .05) increased lung dynamic compliance, and reduced alveolar-arterial oxygen gradient, Acute Physiology and Chronic Health Evaluation II score, percentage of neutrophils, and levels of interleukin-6, interleukin-8, and tumor necrosis factor alpha in bronchoalveolar lavage fluid; there was no significant change in the control group before and after treatment. Intratracheal instillation of perfluorohexane modulates the pulmonary immune microenvironment and supplements current conventional treatments for burn patients with SII.

摘要

烟雾吸入性损伤(SII)与烧伤患者的高发病率和死亡率相关,且缺乏有效的治疗方法。全氟碳化合物(PFCs)对急性肺损伤具有保护作用。我们旨在评估全氟己烷对伴有SII的烧伤患者的治疗效果。将伴有中度严重SII的烧伤患者随机分为对照组(n = 11)和PFC组(n = 12)。对照组接受常规治疗(抗感染、营养支持、抗休克措施及支持治疗)。PFC组在常规治疗基础上接受气管内注入全氟己烷。入院时及3天后,评估治疗效果并分析支气管肺泡灌洗液和血浆中的炎症介质。入院时对照组和PFC组之间无显著差异。3天后,全氟己烷治疗显著(P <.05)提高了肺动态顺应性,降低了肺泡 - 动脉氧梯度、急性生理与慢性健康状况评分II、中性粒细胞百分比以及支气管肺泡灌洗液中白细胞介素 - 6、白细胞介素 - 8和肿瘤坏死因子α的水平;对照组治疗前后无显著变化。气管内注入全氟己烷可调节肺部免疫微环境,并补充目前对伴有SII的烧伤患者的常规治疗。

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