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ARDS发病率死亡率很高,多伴有弥漫性肺部炎症损害。本文研究了脓毒血症相关的ARDS患者的支气管肺泡灌洗液(BALF),于发病48小时内经支气管镜取BALF,又于治疗4天后再经支气管镜取BALF。从58例患者中取得发病初期BALF,其中44例患者于治疗4天后取得二次BALF,这些患者30天存活率为60％。在初期BALF中生存与死亡者中性粒细胞百分比无显著差异,生存者59％,死亡者55％。在二次BALF中生存者中性粒细胞明显下降,为36％,P<0.02;而死亡者则为70％。研究表明,有炎性反应的ARDS患者,凡治疗后BALF中性粒细胞百分比下降5％以上者,30天存活的可能性大为提高。可见,检测中性粒细胞的百分比可预测有肺部炎症的ARDS的预后。ARDS发病1周内中性粒细胞明显减少者大都预后良好,而ARDS危重患者则中性粒细胞数增加。 IL-8是中性粒细胞趋化因子,可吸引中性粒细胞至ARDS患者的肺部炎症损伤区。本研究检测了存活
ARDS morbidity mortality is high, often accompanied by diffuse lung inflammation damage. In this paper, bronchoalveolar lavage fluid (BALF) of patients with sepsis-related ARDS was studied. Bronchoalveolar fluid (BALF) was taken within 48 hours of onset and BALF was taken by bronchoscopy 4 days after treatment. BALF was obtained from 58 patients at the onset of disease, 44 of whom achieved secondary BALF after 4 days of treatment. These patients had a 30-day survival rate of 60%. There was no significant difference in the percentage of neutrophils between surviving and dead in initial BALF, with 59% of survivors and 55% of those killed. Neutrophils in survivors of secondary BALF were significantly decreased by 36%, P <0.02; those who died were 70%. Studies have shown that, ARDS patients with inflammatory response, where the percentage of BALF neutrophils decreased by more than 5% after treatment, the possibility of 30-day survival increased significantly. As can be seen, the percentage of neutrophils detected predicts the prognosis of ARDS with pulmonary inflammation. In the first week after onset of ARDS, the prognosis of neutropenia was better than that of ARDS, while the number of neutrophils in critically ill patients with ARDS increased. IL-8 is a neutrophil chemotactic factor that attracts neutrophils to areas of the lung inflammatory lesion in patients with ARDS. This study examined the survival