摘要
目的观察依达拉奉联合乌司他丁治疗严重肺挫伤的疗效,及其对高迁移率族蛋白B1(HMGB1),可溶性E-选择素(sE-选择素)和可溶性白细胞分化抗原14(sCD14)水平的影响。方法选择2017年1月至2018年12月就诊的严重肺挫伤患者96例,随机分为观察组和对照组,每组48例。对照组予以乌司他丁治疗,观察组在对照组的基础上予以依达拉奉治疗。观察2组治疗后的疗效,2组治疗前后急性肺损伤(Murray)评分,序贯器官衰竭评分(SOFA),急性生理及慢性健康评分Ⅱ(APACHEⅡ评分),氧饱和度(PaO2),二氧化碳分压(PCO2),氧合指数(PaO2/FiO2),气道峰压(PIP),气道阻力(Raw)和肺顺应性(CL)比较。结果观察组气促消失时间、胸痛消失时间、肺间质水肿消失时间、肺部啰音消失时间、抗生素使用时间、机械通气时间和ICU住院时间明显短于对照组,差异有统计学意义(P<0.01)。2组治疗前Murray评分、SOFA评分、APACHEⅡ评分、PaO2、PCO2、PaO2/FiO2、PIP、Raw和CL水平差异无统计学意义(P>0.05),治疗后2组Murray评分、SOFA、APACHEⅡ、PCO2、PIP、Raw、HMGB1、sE-选择素和sCD14较治疗前明显降低,差异有统计学意义(P<0.01),2组PaO2、PaO2/FiO2和CL水平较治疗前明显升高,差异有统计学意义(P<0.01),而观察组降低或者升高幅度较对照组更为明显,差异有统计学意义(P<0.01)。结论依达拉奉联合乌司他丁治疗严重肺挫伤的疗效显著,能够明显改善肺通气功能和肺顺应性,及其机制可能与降低机体HMGB1、sE-选择素和sCD14水平有关。
Objective To investigate the curative effects of edaravone combined with ulinastatin on severe pulmonary contusion,and to observe its effects on the levels of high mobility group box protein B1(HMGB1),soluble E selectin(sE selectin)and soluble leukocyte differentiation antigen 14(sCD14).Methods A total of 96 patients with severe pulmonary contusion who were admitted and treated in our hospital from January 2017 to December 2018 were enrolled in the study,who were randomly divided into observation group(n=48)and control group(n=48).The patients in control group were treated by ulinastatin,however,the patients in observation group,on the basis of control group,were treated by edaravone.The curative effects were observed and compared between the two groups.Moreover the acute lung injury(Murray)scores,sequential organ failure scores(SOFA),acute physiology and chronic health scoreⅡ(APACHEⅡscore),oxygen saturation(PaO2),carbon dioxide partial pressure(PCO2),oxygenation index(PaO2/FiO2),peak airway pressure(PIP),airway resistance(Raw)and lung compliance(CL)before and after treatment were observed and compared between the two groups.Results The extinction time of short breath,extinction time of chest pain,extinction time of pulmonary interstitial tissue edema,extinction time of lung rale,antibiotic usage time,mechanical ventilation time and hospital stay in ICU in observation group were significantly shorter than those in control group(P<0.01).Before treatment there were no significant differences in Murray score,SOFA score,APACHEⅡscore,and the levels of PaO2,PCO2,PaO2/FiO2,PIP,Raw and CL between the two groups(P>0.05).After treatment,the Murray scores,SOFA,APACHEII,PCO2,PIP,Raw,HMGB1,sE selectin and sCD14 in both groups were significantly lower than those before treatment(P<0.01),however,the levels of PaO2,PaO2/FiO2 and CL in both groups were significantly higher than those before treatment(P<0.01).In addition the decrease degree and increase degre in observation group were more significant than those in control g
作者
乔弟
王强
张永明
曾颖鸥
戴斌
万全超
QIAO Di;WANG Qiang;ZHANG Yongming(Department of Thoracic Surgery,Zhoupu Hospital,Shanghai Health Medical College,Shanghai 201318,China)
出处
《河北医药》
CAS
2021年第2期196-200,共5页
Hebei Medical Journal
关键词
肺挫伤
依达拉奉
乌司他丁
炎性反应
疗效
pulmonary contusion
edaravone
ulinastatin
inflammatory response
curative effects
