摘要
目的了解白蛋白和速尿治疗伴有低蛋白血症的老年急性肺损伤或急性呼吸窘迫综合征的疗效。方法选择≥65岁急性肺损伤或急性呼吸窘迫综合征患者40例,随机分为干预组,接受白蛋白和速尿治疗,对照组接受速尿治疗。观察治疗前后的氧合指数、血浆白蛋白水平、液体出入量、60 d病死率及死亡时间。结果2组病人的基线特征基本一致。干预组观察期间氧合指数有所升高(P<0.01),对照组观察期间氧合指数无变化,2组间有显著性差异(P<0.01)。干预组血浆蛋白有明显上升,对照组血浆蛋白无明显改变,2组间有显著性差异(P<0.01)。干预组有更大的液体负平衡(-2035 ml与-1088 ml,P<0.01)。虽然干预组病人病死率略低于对照组,2组病人的病死率无显著性差异。干预组病人死亡中位数时间长于对照组。结论白蛋白联合速尿治疗老年急性肺损伤或急性呼吸窘迫综合征可以提高病人的氧合,有更大的液体负平衡,且可以延长危重老年患者的生存时间。但对患者的病死率无改善。
Objective To investegate the independent pharmacologic effects of albumin and furosemide on hypoproteinemic elderly patients with acute lung injury or acute respiratory distress syndrome. Methods Forty patients with acute lung injury or acute respiratory distress syndrome aged more than 60 were randomly divided into intervention group,receiving treatment of albumin and furosemide,and control group,receiving treatment of furosemide.The oxygenation index,the level of albumin,net fluid loss were measured. Results There were no significant differences in baseline characteristics between two groups.Albumin-treated patients had increased oxygenation index（P〈0.01）,increased serum albumin（4.4 g/L vs 0.95 g/L at day 3,P〈0.01） and more net fluid loss（P〈0.01） throughout the study period.Although the mobidity of albumin-furosemide treated patients was lower,there was no significant difference compared with the control patients.The albumin-furosemide treated patients could live longer than those control patients（P〈0.05）. Conclusions The combination therapy of albumin and furosemide in hypoproteinemic elderly patients with acute lung injury or acute respiratory distress syndrome could significantly improve oxygenation index,increase negative fluid balance,prolong survival time,with no significant benefit in mortality.
出处
《实用老年医学》
CAS
2010年第1期56-58,共3页
Practical Geriatrics
