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成人呼吸窘迫综合征中血栓素与前列环素的释放

Thromboxane and prostacyclin release in adult respiratory distress syndrome.

作者信息

Deby-Dupont G, Braun M, Lamy M, Deby C, Pincemail J, Faymonville M E, Damas P, Bodson L, Lecart M P, Goutier R

出版信息

Intensive Care Med. 1987;13(3):167-74. doi: 10.1007/BF00254700.

Abstract

Plasma thromboxane B2 (TXB2) and 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) were measured in 84 patients at risk of developing adult respiratory distress syndrome (ARDS) (44 patients following multiple trauma, 29 patients following abdominal surgery and 11 patients with acute pancreatitis). Forty-nine of these 84 patients developed an ARDS. High (greater than 140 pg/ml plasma) TXB2 values were found in 52/84 patients. The median values of TXB2 were: 360 pg/ml in multiple injured, 250 pg/ml in abdominal surgery and 410 pg/ml in acute pancreatitis patients. The median TXB2 value was 575 pg/ml in patients developing ARDS and 140 pg/ml in those without this complication: this difference was statistically significant (p less than 0.05). The median values of 6-keto-PGF1 alpha were 55 pg/ml in multiple injured, 25 pg/ml in abdominal surgery and 120 pg/ml in acute pancreatitis patients. The median 6-keto-PGF1 alpha value was 122 pg/ml in ARDS patients and 25 pg/ml in non-ARDS patients (statistically significant: p less than 0.05). High TXB2 and 6-keto-PGF1 alpha values were particularly related to sepsis in abdominal surgery patients (p less than 0.05) and in multiple injured patients (p less than 0.01). No relation could be established between abnormal TXB2 or 6-keto-PGF1 alpha values and death. High TXB2 values often persisted for several days and were observed particularly at the time ARDS diagnostic criteria were fulfilled.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

对84例有发生成人呼吸窘迫综合征(ARDS)风险的患者(44例多发性创伤患者、29例腹部手术患者和11例急性胰腺炎患者)测定了血浆血栓素B2(TXB2)和6-酮-前列腺素F1α(6-酮-PGF1α)。这84例患者中有49例发生了ARDS。84例患者中有52例TXB2值较高(血浆中大于140 pg/ml)。TXB2的中位数为:多发性创伤患者360 pg/ml,腹部手术患者250 pg/ml,急性胰腺炎患者410 pg/ml。发生ARDS的患者TXB2中位数为575 pg/ml,未发生该并发症的患者为140 pg/ml:差异有统计学意义(p<0.05)。6-酮-PGF1α的中位数为:多发性创伤患者55 pg/ml,腹部手术患者25 pg/ml,急性胰腺炎患者120 pg/ml。ARDS患者6-酮-PGF1α中位数为122 pg/ml,非ARDS患者为25 pg/ml(差异有统计学意义:p<0.05)。高TXB2和6-酮-PGF1α值尤其与腹部手术患者(p<0.05)和多发性创伤患者(p<0.01)的脓毒症相关。TXB2或6-酮-PGF1α值异常与死亡之间未发现关联。高TXB2值常持续数天,尤其在符合ARDS诊断标准时观察到。(摘要截短至250字)

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