奥曲肽联合美罗培南治疗脓毒症合并重度急性呼吸窘迫综合征对患者肺血管阻力及T淋巴细胞亚群的影响OA
Effect of Octreotide combined with Meropenem on pulmonary vascular resistance and T lymphocyte subsets in patients with sepsis complicated by severe acute respiratory distress syndrome
目的 探讨奥曲肽联合美罗培南治疗脓毒症合并重度急性呼吸窘迫综合征对患者肺血管阻力及T淋巴细胞亚群的影响.方法 选取2023年1月至2025年1月上饶东信第五医院收治的130例脓毒症合并重度急性呼吸窘迫综合征患者作为研究对象,按随机数字表法分为对照组(65例)和观察组(65例).对照组单用美罗培南治疗,观察组采用奥曲肽联合美罗培南治疗,两组均治疗7 d.比较两组临床有效率、不良反应和治疗前后肺血管阻力指标及T淋巴细胞亚群水平.结果 对照组和观察组各脱落5例,最终两组各纳入60例.观察组临床有效率高于对照组,差异有统计学意义(P＜0.05).两组治疗后肺血管阻力(PVR)、肺血管通透性指数(PVPI)和血管外肺水指数(EVLWI)均低于本组治疗前,且观察组PVR、PVPI和EVLWI均低于对照组,差异有统计学意义(P＜0.05).观察组治疗后CD3+、CD4+和CD4+/CD8+水平均高于对照组,观察组CD8+水平低于对照组,差异有统计学意义(P＜0.05).两组治疗期间不良反应总发生率比较,差异无统计学意义(P＞0.05).结论 奥曲肽联合美罗培南能够有效降低脓毒症合并重度急性呼吸窘迫综合征患者的肺血管阻力,并帮助患者免疫系统恢复,具有良好的临床疗效.
Objective To investigate the effects of Octreotide combined with Meropenem on pulmonary vascular resistance and T lymphocyte subsets in patients with sepsis complicated by severe acute respiratory distress syndrome.Methods A to-tal of 130 patients with sepsis complicated by severe acute respiratory distress syndrome admitted to Dongxin Fifth Hospital from January 2023 to January 2025 were selected as the study subjects.They were divided into the control group(65 cases)and the observation group(65 cases)using random number table method.The control group was treated with Meropenem alone,while the observation group received a combination of Octreotide and Meropenem.Both groups were treated for 7 days.The clinical efficacy rate,adverse reactions,and differences in pulmonary vascular resistance indicators and T lymphocyte subset levels before and after treatment were compared between the two groups.Results Five cases were lost to follow-up in both the control and observation groups,with 60 cases ultimately were included in each group.The clinical efficacy rate of the observation group was higher than that of the control group,with a statistically significant difference(P＜0.05).After treatment,pulmonary vascular resistance(PVR),pulmonary vascular permeability index(PVPI),and extravas-cular lung water index(EVLWI)in both groups were lower than those before treatment,and the levels of PVR,PVPI,EVLWI in the observation group were lower than those in the control group,with statistically significant differences(P＜0.05).After treatment,the levels of CD3+,CD4+,and CD4+/CD8+ratio in the observation group were higher than those in the control group,while the CD8+level in the observation group was lower than that in the control group,with statis-tically significant differences(P＜0.05).There was no statistically significant difference in the total incidence of adverse re-actions between the two groups during treatment(P＞0.05).Conclusion Octreotide combined with Meropenem effectively reduces pulmonary vascular resistance and aids in the recovery of the immune system in patients with sepsis complicated by severe acute respiratory distress syndrome,demonstrating good clinical efficacy.
姜建泽;黄丽华;朱强;杨龙辉
江西省上饶东信第五医院重症医学科,江西上饶 334000江西省上饶东信第五医院重症医学科,江西上饶 334000江西省上饶东信第五医院重症医学科,江西上饶 334000江西省上饶东信第五医院重症医学科,江西上饶 334000
医药卫生
奥曲肽美罗培南脓毒症重度急性呼吸窘迫综合征肺血管阻力T淋巴细胞亚群
OctreotideMeropenemSepsisSevere acute respiratory distress syndromePulmonary vascular resistanceT lymphocyte subsets
《中国当代医药》 2026 (21)
26-30,5
江西省卫生健康委科技计划项目(202120112、202212784).
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