高容量血液滤过联合前列地尔治疗新生儿感染性休克合并急性呼吸窘迫综合征的效果

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Abstract Objective To analyze the application value of high volume hemofiltration (HVHF) combined with Alprostadil and the effect on high mobility group box 1 (HMGB1) and matrix metalloproteinase-9 (MMP-9) levels. Methods From January 2016 to June 2018, 80 cases of neonatal septic shock complicated with ARDS in West China-Guang′an Hospital, Sichuan University were divided into observation group and control group according to random envelope method, 40 cases in each group. The control group was treated with routine treatment combined with continuous venous hemofiltration intervention, while the observation group was treated with HVHF combined with alprostadil regimen was used to treat the patients. The basic treatment conditions of the patients were counted, the changes of respiratory function index [respiratory rate (RR), arterial oxygen partial pressure (PaO2), inhaled oxygen concentration (FiO2), oxygenation index (OI), positive end-expiratory pressure (PEEP), airway resistance (AR)], inflammatory index in blood [procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6) and CD4+/CD8+] and the levels of HMGB1 and MMP-9 in blood were detected. Results Respiratory ventilation time and ICU hospitalization time in the observation group were shorter than those in the control group, the differences were statistically significant (P < 0.05); RR, FiO2, PEEP and AR in the observation group were lower than those in the control group at 3 d and 6 d of treatment, and PaO2 and OI levels were higher than those in the control group, the differences were statistically significant (P < 0.05). The levels of PCT, CRP, IL-6 and CD4+/CD8+ in the observation group were lower than those in the control group, the differences were statistically significant (P < 0.05); the levels of HMGB1 and MMP-9 in the observation group were lower than those in the control group at 3 d and 6 d after treatment, the differences were statistically significant (P < 0.05). Conclusion The combination of HVHF and alprostadil can effectively improve the clinical efficacy of the traditional regimen in the treatment of neonatal septic shock complicated with ARDS, improve the pulmonary function and inflammatory state in vivo, and reduce the levels of HMGB1 and MMP-9 in blood.

Key words： High volume hemofiltration Alprostadil Neonatal septic shock Acute respiratory distress syndrome High mobility group box 1 Matrix metalloproteinase-9

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XIONG Lingli. Effect of high volume hemofiltration combined with Alprostadil in the treatment of neonatal septic shock complicated with acute respiratory distress syndrome[J]. 中国医药导报, 2020, 17(2): 76-80.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I2/76

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