Effects of nitroglycerin on ARDS patients with low tidal volume ventilation strategies+ pulmonary reexpansion after cardiopulmonary function, inflammatory factors and immune function

doi:10.3877/cma.j.issn.1674-6902.2020.05.008

Abstract

Abstract:

Objective

To analysis of nitroglycerin on acute respiratory distress syndrome (ARDS) patients with low tidal volume ventilation strategies + pulmonary reexpansion after cardiopulmonary function, inflammatory factors and immune function.

Methods

From September 2015 to May 2019, 98 patients with ARDS were randomly divided intoNitroglycerin group 50 cases and control group 48 cases. All patients were treated with small tidal volume ventilation strategy and pulmonary revascularization. The Nitroglycerin group was treated with intravenous nitroglycerin injection. The cardiopulmonary function, inflammatory factors and immune function associated indexes in the two groups were detected before treatment, 6 h and 24 h after treatment.

Results

6 h and 24 h after treatment, the left ventricular ejection fraction and cardiac index (CI) were significantly higher than those before treatment, serum N-terminal B type brain natriuretic peptide (NT-proBNP) levels were significantly lower than those before treatment, and the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV₁) and FEV₁/FVC were significantly higher than those before treatment (P<0.05). 6 h after treatment, there were no significant differences in cardiopulmonary function indexes between the two groups (P>0.05). 24 h after treatment, the improvement of cardiopulmonary function in theNitroglycerin group was more significant than that in the control group (P<0.05). 6 h and 24 h after treatment, the levels of serum C reactive protein (CRP), procalcitonin (PCT) and interleukin-6 (IL-6) were significantly lower while the levels of CD₃⁺ , CD₄⁺ and CD₄⁺ /CD₈⁺ were significantly higher than those before treatment (P<0.05). 6 h and 24 h after treatment, the levels of CRP, PCT and IL-6 in theNitroglycerin group were significantly lower while the levels of CD₃⁺ , CD4⁺ and CD₄⁺ /CD₈⁺ were significantly higher than those in the control group (P<0.05).

Conclusion

Nitroglycerin combined with low tidal volume ventilation and lung recruitment maneuver in the treatment of ARDS can play a better role in protecting the cardiopulmonary function. The regimen can effectively relieve the inflammatory reactions and enhance immune function.

Key words: Nitroglycerin, Acute respiratory distress syndrome, Cardiopulmonary function, Inflammatory factor, Immune function

Yan Gu, Wen Jiang, Lixing Zhang. Effects of nitroglycerin on ARDS patients with low tidal volume ventilation strategies+ pulmonary reexpansion after cardiopulmonary function, inflammatory factors and immune function[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2020, 13(05): 618-622.

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References 32

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组　别	例数	时间	左室射血分数(%)	CI(L/mm·m²)	NT-proBNP(pg/L)
硝酸甘油组	50	治疗前	32.66±5.23	1.83±0.39	249.60±31.81
		治疗后6 h	39.36±4.55^a	2.16±0.41	231.58±23.69
		治疗后24 h	51.50±5.97^a	2.93±0.38^a	205.61±15.48^a
F值			320.236	275.680	459.330
P值			0.000	0.000	0.000
对照组	48	治疗前	32.47±5.16	1.90±0.35	251.52±30.87
		治疗后6 h	39.47±4.61	2.27±0.37	230.06±23.88
		治疗后24 h	46.15±6.29	2.69±0.36	219.13±16.76
F值			285.260	227.416	384.752
P值			0.000	0.000	0.000

组　别	例数	时间	左室射血分数(%)	CI(L/mm·m²)	NT-proBNP(pg/L)
硝酸甘油组	50	治疗前	32.66±5.23	1.83±0.39	249.60±31.81
		治疗后6 h	39.36±4.55^a	2.16±0.41	231.58±23.69
		治疗后24 h	51.50±5.97^a	2.93±0.38^a	205.61±15.48^a
F值			320.236	275.680	459.330
P值			0.000	0.000	0.000
对照组	48	治疗前	32.47±5.16	1.90±0.35	251.52±30.87
		治疗后6 h	39.47±4.61	2.27±0.37	230.06±23.88
		治疗后24 h	46.15±6.29	2.69±0.36	219.13±16.76
F值			285.260	227.416	384.752
P值			0.000	0.000	0.000

组　别	例数	时　间	FVC(L)	FEV₁(L)	FEV₁/FVC(%)
硝酸甘油组	50	治疗前	2.23±0.50	1.16±0.38	52.60±1.81
		治疗后6 h	2.36±0.54	1.32±0.45	56.54±3.79
		治疗后24 h	2.74±0.58^a	1.75±0.47^a	65.71±2.48^a
F值			12.554	11.057	19.307
P值			0.000	0.000	0.000
对照组	48	治疗前	2.20±0.48	1.14±0.36	53.28±1.69
		治疗后6 h	2.34±0.51	1.27±0.34	54.23±3.63
		治疗后24 h	2.49±0.53	1.43±0.40	62.82±1.87
F值			9.719	8.748	14.094
P值			0.000	0.000	0.000

组　别	例数	时　间	FVC(L)	FEV₁(L)	FEV₁/FVC(%)
硝酸甘油组	50	治疗前	2.23±0.50	1.16±0.38	52.60±1.81
		治疗后6 h	2.36±0.54	1.32±0.45	56.54±3.79
		治疗后24 h	2.74±0.58^a	1.75±0.47^a	65.71±2.48^a
F值			12.554	11.057	19.307
P值			0.000	0.000	0.000
对照组	48	治疗前	2.20±0.48	1.14±0.36	53.28±1.69
		治疗后6 h	2.34±0.51	1.27±0.34	54.23±3.63
		治疗后24 h	2.49±0.53	1.43±0.40	62.82±1.87
F值			9.719	8.748	14.094
P值			0.000	0.000	0.000

组　别	例数	时　间	CRP(mg/L)	PCT(ng/L)	IL-6(μg/L)
硝酸甘油组	50	治疗前	156.76±21.11	27.69±2.17	13.38±2.11
		治疗后6 h	101.04±13.14^a	17.51±2.15^a	8.05±2.03^a
		治疗后24 h	78.17±12.72^a	12.63±2.03^a	6.79±1.06^a
F值			329.337	75.248	142.081
P值			0.000	0.000	0.000
对照组	48	治疗前	160.16±23.80	27.75±2.23	13.42±2.15
		治疗后6 h	126.72±15.16	20.02±2.22	11.31±2.07
		治疗后24 h	91.05±13.12	15.01±2.14	9.14±1.11
F值			295.227	71.474	108.007
P值			0.000	0.000	0.000

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