【摘要】：目的檢測(cè)患者血清IL-6和CRP水平,探討急性A型主動(dòng)脈夾層并發(fā)肺損傷與炎性反應(yīng)的相關(guān)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(dòng)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(guò)心臟彩超等影像學(xué)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(shù)前氧合指數(shù)≤200定義為肺損傷陽(yáng)性。本研究根據(jù)此次定義把患者分為肺損傷陽(yáng)性組和肺損傷陰性組,其中216例患者陽(yáng)性組72例,陰性組144例。216例患者住院后每隔4 h抽取動(dòng)脈血進(jìn)行計(jì)算氧合指數(shù)。同時(shí)抽取血標(biāo)本,用于統(tǒng)一檢測(cè)C反應(yīng)蛋白(CRP)、白介素6(IL-6)水平。評(píng)估患者血清CRP水平和IL-6水平與急性A型主動(dòng)脈夾層并發(fā)肺損傷的關(guān)系。結(jié)果肺損傷陽(yáng)性組與陽(yáng)性組兩組患者分別在性別、年齡、吸煙喝酒、常見(jiàn)慢性病等方面的差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)前實(shí)驗(yàn)學(xué)檢查、心臟彩超等幾項(xiàng)檢查差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);比較兩組患者,肺損傷陽(yáng)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(jì)學(xué)意義(P0.05);進(jìn)一步研究肺損傷患者血清CRP、IL-6水平與氧合指數(shù)的關(guān)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(yīng)蛋白和白介素6水平均迅速上升,達(dá)到峰值水平,而后,隨著患者炎性反應(yīng)減弱,氧合指數(shù)呈現(xiàn)上升的趨勢(shì)。結(jié)論炎性反應(yīng)在急性A型主動(dòng)脈夾層引發(fā)肺損傷中起關(guān)鍵作用,隨著患者患病時(shí)間的延長(zhǎng),患者血清C反應(yīng)蛋白和白介素6水平與低氧血癥關(guān)系密切。積極在術(shù)前予以抗炎治療,可能會(huì)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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