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目的探讨缺氧对急性呼吸窘迫综合征(ARDS)患者消化道出血及肝功能影响。方法 65例 ARDS 患者分为呼衰指数<100 mmHg(A 组)与呼衰指数100～200 mmHg(B 组)二组,比较消化道出血发生率、红细胞(RBC)、血红蛋白(HB)、及肝功能的变化。结果 ARDS 患者可发生消化道出血,其发生率为15.4%,A 组消化道出血率高于 B 组(P<0.05),且 A 组 RBC、HB 低于 B 组(P<0.05);非消化道出血 ARDS 患者中,A 组 RBC、HB 低于 B 组(P<0.01);A 组患者病前健康状况优于 B 组(P<0.05),但消化道出血发生率及 RBC、血红蛋白减少程度大于 B 组(P<0.05,P<0.01);A 组丙氨酸氨基转移酶(ALT)高于 B 组而血清总蛋白(TP)、血清白蛋白(Alb)低于 B 组(P<0.05)。结论①严重缺氧促发了 ARDS 患者 RBC、HB 减少及消化道出血的发生;缺氧越严重,RBC、HB 减少越明显,消化道出血发生率越高。②严重缺氧促发了 ARDS 患者 ALT 增高,TP、Alb 降低,并随缺氧加重而加重。
Objective To investigate the effects of hypoxia on gastrointestinal bleeding and liver function in patients with acute respiratory distress syndrome (ARDS). Methods A total of 65 patients with ARDS were divided into two groups: the group with respiratory failure index <100 mmHg (group A) and the group with respiratory failure index 100-200 mmHg (group B). The incidences of gastrointestinal bleeding, red blood cells (RBC), hemoglobin Changes in liver function. Results The incidence of gastrointestinal bleeding in ARDS patients was 15.4%. The digestive tract hemorrhage rate in group A was higher than that in group B (P <0.05), and the levels of RBC and HB in group A were lower than those in group B (P <0.05) Among ARDS patients with hemorrhage, the RBC and HB in group A were lower than those in group B (P <0.01); The premorbid health status in group A was better than that in group B (P <0.05), but the incidence of gastrointestinal bleeding and the decrease of RBC and hemoglobin (P <0.05, P <0.01). The ALT in group A was higher than that in group B, and the levels of serum total protein (TP) and serum albumin (Alb) ). Conclusions ① Severe hypoxia triggers the reduction of RBC, HB and the incidence of gastrointestinal bleeding in patients with ARDS. The more severe hypoxia, the more obvious the decrease of RBC and HB and the higher incidence of gastrointestinal bleeding. ② Severe hypoxia caused ARDS patients with elevated ALT, TP, Alb decreased, and aggravated with hypoxia.