回顾性分析氨茶碱注射液对脓毒性休克患者毛细血管渗漏的影响
The Effect of Aminophylline Injection on Capillary Leakage in Patients with Septic Shock Was Retrospectively Analyzed
摘要: 目的:分析常规剂量氨茶碱注射液对脓毒性休克患者毛细血管渗漏的影响。方法:采用回顾性分析,选取我院2018年08月~2021年07月收治的脓毒性休克患者共83例,按照治疗过程中是否使用氨茶碱注射液分为A组(n = 41)及B组(n = 42)。A组接受常规治疗(液体复苏、抗感染、稳定血流动力学、呼吸功能支持等措施),B组在常规治疗的基础上静脉泵注氨茶碱注射液500 mg∙qd,比较两组患者治疗前及治疗48 h后的毛细血管渗漏指数(CLI)变化。结果:经治疗48小时后,B组CLI较A组下降更明显(P < 0.05),死亡率低于A组。结论:氨茶碱注射液可减轻脓毒性休克患者毛细血管的渗漏,降低死亡率。
Abstract: Objective: To analyze the effect of aminophylline on capillary leakage influence in patients with septic shock. Methods: A total of 83 patients with septic shock admitted to our hospital from August 2018 to July 2021 were retrospectively analyzed and divided into group A (n = 41) and group B (n = 42) according to whether aminophylline injection was used in the treatment process. Group A re-ceived routine treatment (fluid resuscitation, anti-infection, hemodynamics stabilization, respira-tory function support, etc.), and group B received intravenous infusion of aminophylline injection 500 mg∙qd on the basis of routine treatment. The changes of capillary leakage index (CLI) between the two groups were compared before treatment and 48 h after treatment. Results: After 48 hours of treatment, the capillary leakage index (CLI) in group B decreased more significantly than that in group A (P < 0.05). Conclusion: Aminophylline injection can reduce capillary leakage in patients with septic shock.
文章引用:黎海燕, 李波, 刘俊, 李泰兴, 陈敏, 刘跃昆. 回顾性分析氨茶碱注射液对脓毒性休克患者毛细血管渗漏的影响[J]. 临床医学进展, 2022, 12(6): 5370-5374. https://doi.org/10.12677/ACM.2022.126778

参考文献

[1] 许小泽, 刘雪燕, 郑标林, 许智坤. 脓毒症毛细血管渗漏综合征的机制及临床治疗探究[J]. 当代医学杂志, 2020, 26(16): 189-191.
[2] Fleischmann-Struzek, C., Mellhammar, L., Rose, N., Cassini, A., Rudd, K.E., Schlattmann, P., et al. (2020) Incidence and Mortality of Hospital- and ICU-Treated Sepsis: Results from an Updated and Expanded Sys-tematic Review and Meta-Analysis. Intensive Care Medicine, 46, 1552-1562. [Google Scholar] [CrossRef] [PubMed]
[3] Fleischmann, C., Scherag, A., Adhikari, N.K.J., Hartog, C.S., Tsaganos, T., Schlattmann, P., Angus, D.C. and Reinhart, K. (2016) Assessment of Global Incidence and Mortality of Hospital-Treated Sepsis. Current Estimates and Limitations. American Journal of Respiratory and Critical Care Medi-cine, 193, 259-272. [Google Scholar] [CrossRef
[4] Shapiro, L. and Gelfand, J.A. (1993) Cytokines and Sepsis: Pathophysiology and Therapy. New Horizons, 1, 13-22.
[5] Bone, R.C., Grodzin, C.J. and Balk, R.A. (1997) Sepsis: A New Hypothesis for Pathogenesis of the Disease Process. Chest, 112, 235-243. [Google Scholar] [CrossRef] [PubMed]
[6] Fleck, A., Raines, G., Hawker, F., Trotter, J., Wallace, P.I., Ledingham, I.M. and Calman, K.C. (1985) Increased Vascular Permeability: A Major Cause of Hypoalbuminaemia in Disease and Injury. Lancet, 1, 781-784. [Google Scholar] [CrossRef
[7] 中华医学会重症医学分会. 重症医学[M]. 北京: 人民卫生出版社, 2013: 29-33.
[8] Fairclough, E., Cairns, E., Hamilton, J. and Kelly, C. (2009) Evaluation of a Modified Early Warning System for Acute Medical Admissions and Comparison with C-Reactive Protein/albumin Ratio as a Pre-dictor of Patient Outcome. Clinical Medicine, 9, 30-33. [Google Scholar] [CrossRef] [PubMed]
[9] Foy, T., Marion, J., Brigham, K.L. and Harris, T.R. (1979) Isoproterenol and Aminophylline Reduce Lung Capillary Filtration During High Permeability. Journal of Applied Physiology: Respiratory, Environmental and Exercise Physiology, 46, 146-151. [Google Scholar] [CrossRef] [PubMed]
[10] Harada, H., Ishizaka, A., Yonemaru, M., Mallick, A.A., Hatherill, J.R., Zheng, H., Lilly, C.M., O’Hanley, P.T. and Raffin, T.A. (1989) The Effects of Aminophylline and Pent-oxifylline on Multiple Organ Damage after Escherichia Coli Sepsis. American Review of Respiratory Disease, 140, 974-980. [Google Scholar] [CrossRef] [PubMed]
[11] Moller, A.D. and Grände, P.O. (1999) Low-Dose Prosta-cyclin Is Superior to Terbu Taline and Aminophylline in Reducing Capillary Permeability in Cat Skeletal Muscle in Vivo. Critical Care Medicine, 27, 130-136. [Google Scholar] [CrossRef] [PubMed]
[12] Churchill, P.C. (1982) Renal Effects of 2-Chloroadenosine and Their Antagonism by Aminophylline in Anesthetized Rats. Journal of Pharmacology and Ex-perimental Therapeutics, 222, 319-323.
[13] Sato, K., Stelzner, T.J., O’Brien, F.R., Weil, J.V. and Welsh, C.H. (1991) Pentoxiphylline Lessens the Endotoxemia-Induced Increase in Albumin Clearance across Pulmonary Artery Endothelial Monolayers with and without Neutrophils. American Journal of Respiratory Cell and Molecular Biology, 4, 219-227. [Google Scholar] [CrossRef] [PubMed]
[14] Stelzner, T.J., Weil, J.V. and O’Brian, R.F. (1989) Role of Cyclic Adenosine Monophosphate in the Induction of Endothelial Barrier Properties. Journal of Cellular Physiology, 139, 157-166. [Google Scholar] [CrossRef] [PubMed]
[15] Chen, Q., Zhou, X., Ruonan, H., Zhou, Z., Wang, Z., Chen, Y., Weng, J. and Xu, J. (2021) Aminophylline Modulates the Permeability of Endothelial Cells via the Slit2-Robo4 Pathway in Lipopolysaccharide-Induced Inflammation. Experimental and Therapeutic Medicine, 22, Article No. 1042. [Google Scholar] [CrossRef] [PubMed]