Medrxiv:武汉中心医院研究称,过度炎症反应或参与ARDS进程

2020-02-25 文韬 中国循环杂志

近期,武汉中心医院重症医学科医生在预印本网站Medrxiv刊文称,出现呼吸窘迫综合征(ARDS)的新冠肺炎患者,病死率接近50%。

近期,武汉中心医院重症医学科医生在预印本网站Medrxiv刊文称,出现呼吸窘迫综合征(ARDS)的新冠肺炎患者,病死率接近50%。
 
呼吸窘迫综合征是急性肺损伤的严重阶段或类型,其临床特征呼吸频速和窘迫,进行性低氧血症。 
研究分析了在1月2日-2月1日入院的109名患者。有53人出现了ARDS。
 
轻度ARDS有1人(5.3%)死亡,中度有15人(62.5%)死亡,重度ARDS有10人,全部死亡。
 
出现了ARDS的患者中位年龄是61岁,合并高血压糖尿病、心脑血管病等的比例高,影像学上都有肺炎表现。而未发生ARDS的患者年龄小12岁。
 
出现ARDS的患者淋巴细胞计数更低,而C-反应蛋白、乳酸、中性粒细胞计数、降钙素原、D-二聚体、血尿素氮、乳酸脱氢酶等指标显著升高,提示过度的炎症反应参与了ARDS的病理进程。
 
研究发现,血乳酸水平、D-二聚体、淋巴细胞计数等与ARDS严重程度明显相关性。
 
但研究称,中重度ARDS患者,尽管有较高比例的患者接受糖皮质激素治疗、高流量鼻导管吸氧,但并未挽回更多患者的生命。气管插管、ECMO等能否改善预后,也需要更多的研究。
 
  
研究分析了在1月2日-2月1日入院的109名患者。有53人出现了ARDS。
 
轻度ARDS有1人(5.3%)死亡,中度有15人(62.5%)死亡,重度ARDS有10人,全部死亡。
 
出现了ARDS的患者中位年龄是61岁,合并高血压糖尿病、心脑血管病等的比例高,影像学上都有肺炎表现。而未发生ARDS的患者年龄小12岁。
 
出现ARDS的患者淋巴细胞计数更低,而C-反应蛋白、乳酸、中性粒细胞计数、降钙素原、D-二聚体、血尿素氮、乳酸脱氢酶等指标显著升高,提示过度的炎症反应参与了ARDS的病理进程。
 
研究发现,血乳酸水平、D-二聚体、淋巴细胞计数等与ARDS严重程度明显相关性。

但研究称,中重度ARDS患者,尽管有较高比例的患者接受糖皮质激素治疗、高流量鼻导管吸氧,但并未挽回更多患者的生命。气管插管、ECMO等能否改善预后,也需要更多的研究。
 
原始出处:
Yanli Liu, et al. Clinical features and progression of acute respiratory distress syndrome in coronavirus disease 2019. medRxiv preprint, doi: https://doi.org/10.1101/2020.02.17.20024166

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    2020-07-25 drwjr
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