甲泼尼龙与地塞米松治疗过敏性休克的临床疗效分析(1)
[摘要] 目的 探讨采用甲泼尼龙与地塞米松治疗过敏性休克的效果，为合理用药提供科学的理论依据。方法 回顾性分析在2016年3月—2017年6月期间该科室调查的患过敏性休克的患者122例资料，根据治疗药物不同分为两组，对照组在基础治疗的基础上采用地塞米松配合治疗，观察组在基础治疗的基础上采用甲泼尼龙治疗，比较两组临床上的治疗效果。结果 和对照组比较，观察组患者头昏、意识不清等症状缓解时间显著缩短，均差异有统计学意义(P<0.05)；观察组治疗前后变化值显著高于对照组，差异有统计学意义(t=6.744，P<0.001)；观察组总有效率为93.44%，对照组总有效率为72.13%，观察组治疗效果明显优于对照组，差异有统计学意义(Z=-3.380，P=0.005)。两组治疗中未见明显不良反应。结论 采用甲泼尼龙治疗过敏性休克治愈效果优于地塞米松治疗，值得临床推广应用。
[关键词] 过敏性休克；甲泼尼龙；地塞米松
[中图分类号] R593.1 [文献标识码] A [文章编号] 1674-0742(2018)10(b)-0106-03
[Abstract] Objective To investigate the effect of methylprednisolone and dexamethasone in the treatment of anaphylactic shock， and provide a scientific theoretical basis for rational drug use. Methods A retrospective analysis of 122 patients with anaphylactic shock from March 2016 to June 2017 was conducted. The patients were divided into two groups according to the treatment drugs. The control group was based on the basic treatment andcombined with Dexamethasone treatment， the observation group was treated with methylprednisolone on the basis of basic treatment， and the clinical effects of the two groups were compared. Results Compared with the control group， the time to relieve symptoms such as dizziness and unconsciousness in the observation group was significantly shortened， and the difference was statistically significant (P<0.05). The change value of the observation group before and after treatment was significantly higher than that of the control group. The difference was statistically significant(t=6.744， P<0.001)； the total effective rate was 93.44% in the observation group and 72.13% in the control group. The therapeutic effect of the observation group was significantly better than that of the control group， and the difference was statistically significant (Z=-3.380，P=0.005). No significant adverse reactions were observed in the two groups. Conclusion The treatment of anaphylactic shock with methylprednisolone is better than dexamethasone， which is worthy of clinical application.
[Key words] Anaphylactic shock； Methylprednisolone； Dexamethasone
過敏性休克是一种会威胁生命健康的全身多系统速发变态反应，其反应机制是Ⅰ型变态反应，一部分其诱发机制是其他免疫学反应[1]。患者在暴露于过敏原的条件下，可迅速出现全身潮红、哮喘、窒息、血压下降、呼吸困难、心律失常、意识丧失、休克甚至死亡的症状[2-3]。现阶段，糖皮质激素是治疗过敏性休克的一种有效药物，其具有抗炎、抗过敏及免疫抑制的作用，而在糖皮质激素里面甲泼尼龙琥珀酸钠以无需肝脏转化，见效快而被广泛应用于临床治疗。地塞米松则需经肝脏代谢起效，与甲泼尼龙琥珀酸钠相比，时间延长，对于重症患者疗效差。2016年3月—2017年6月期间方便选取122例在该科室治疗的病例研究结果显示，在常规治疗的基础上，采用泼尼松龙琥珀酸钠配合治疗，能取得更好的疗效，现报道如下。
1 资料与方法
1.1 一般资料
方便选取122例该科室调查的过敏性休克患者资料作为研究对象。随机分为两组：对照组和观察组，每组61例。其中对照组患者女性25例，男性36例，年龄23～66岁，平均年龄(49.0±3.23)岁；观察组患者女性24例，男性37例，年龄21～69岁，平均年龄(51.0±1.69)岁，所有患者同意配合参加该次临床研究并签署知情同意书，且该次临床研究报伦理委员会批准。两组患者在性别、年龄大小等方面差异无统计学意义(P>0.05)，具有可比性。, 百拇医药(刘丽华)
[关键词] 过敏性休克；甲泼尼龙；地塞米松
[中图分类号] R593.1 [文献标识码] A [文章编号] 1674-0742(2018)10(b)-0106-03
[Abstract] Objective To investigate the effect of methylprednisolone and dexamethasone in the treatment of anaphylactic shock， and provide a scientific theoretical basis for rational drug use. Methods A retrospective analysis of 122 patients with anaphylactic shock from March 2016 to June 2017 was conducted. The patients were divided into two groups according to the treatment drugs. The control group was based on the basic treatment andcombined with Dexamethasone treatment， the observation group was treated with methylprednisolone on the basis of basic treatment， and the clinical effects of the two groups were compared. Results Compared with the control group， the time to relieve symptoms such as dizziness and unconsciousness in the observation group was significantly shortened， and the difference was statistically significant (P<0.05). The change value of the observation group before and after treatment was significantly higher than that of the control group. The difference was statistically significant(t=6.744， P<0.001)； the total effective rate was 93.44% in the observation group and 72.13% in the control group. The therapeutic effect of the observation group was significantly better than that of the control group， and the difference was statistically significant (Z=-3.380，P=0.005). No significant adverse reactions were observed in the two groups. Conclusion The treatment of anaphylactic shock with methylprednisolone is better than dexamethasone， which is worthy of clinical application.
[Key words] Anaphylactic shock； Methylprednisolone； Dexamethasone
過敏性休克是一种会威胁生命健康的全身多系统速发变态反应，其反应机制是Ⅰ型变态反应，一部分其诱发机制是其他免疫学反应[1]。患者在暴露于过敏原的条件下，可迅速出现全身潮红、哮喘、窒息、血压下降、呼吸困难、心律失常、意识丧失、休克甚至死亡的症状[2-3]。现阶段，糖皮质激素是治疗过敏性休克的一种有效药物，其具有抗炎、抗过敏及免疫抑制的作用，而在糖皮质激素里面甲泼尼龙琥珀酸钠以无需肝脏转化，见效快而被广泛应用于临床治疗。地塞米松则需经肝脏代谢起效，与甲泼尼龙琥珀酸钠相比，时间延长，对于重症患者疗效差。2016年3月—2017年6月期间方便选取122例在该科室治疗的病例研究结果显示，在常规治疗的基础上，采用泼尼松龙琥珀酸钠配合治疗，能取得更好的疗效，现报道如下。
1 资料与方法
1.1 一般资料
方便选取122例该科室调查的过敏性休克患者资料作为研究对象。随机分为两组：对照组和观察组，每组61例。其中对照组患者女性25例，男性36例，年龄23～66岁，平均年龄(49.0±3.23)岁；观察组患者女性24例，男性37例，年龄21～69岁，平均年龄(51.0±1.69)岁，所有患者同意配合参加该次临床研究并签署知情同意书，且该次临床研究报伦理委员会批准。两组患者在性别、年龄大小等方面差异无统计学意义(P>0.05)，具有可比性。, 百拇医药(刘丽华)