摘要
目的分析乌司他丁对急性窘迫综合征(ARDS)患者血气指标及血清肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)、白介素-6(IL-6)、细胞间黏附分子-1(ICAM-1)水平的影响。方法根据随机数字表法将南方医科大学南方医院白云分院2017年5月至2021年3月收治的82例ARDS患者分为对照组与观察组,各41例。两组患者均予以抗感染、加强营养支持等常规治疗,对照组患者在此基础上采用机械通气治疗,观察组患者在对照组的基础上采用乌司他丁治疗,两组患者均治疗7 d。对比两组患者临床指标,治疗前后血气指标与血清炎性因子水平,治疗期间不良反应发生情况。结果与对照组比,观察组患者急性生理和慢性健康状况评分Ⅱ(APACHEⅡ)评分显著降低,呼吸机支持时间、ICU住院时间、总住院时间均显著缩短;与治疗前比,治疗后两组患者的动脉血二氧化碳分压(PaCO_(2))及血清TNF-α、IL-1β、IL-6、ICAM-1水平均显著降低,且观察组显著低于对照组;治疗后两组患者pH值、动脉血氧分压(PaO2)、血氧饱和度(SaO2)均显著升高,且观察组显著高于对照组(均P<0.05);治疗期间两组患者不良反应总发生率比较,差异无统计学意义(P>0.05)。结论乌司他丁治疗ARDS可有效改善患者血气指标,同时抑制机体炎症反应,且安全性良好。
Objective To analyze the effects of Ulinastatin on blood gas indicators and serum tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-6(IL-6)and intercellular adhesion molecule-1(ICAM-1)of patients with acute respiratory distress syndrome(ARDS).Methods According to the random number table method,82 patients with ARDS admitted to the Baiyun Branch of Southern Hospital of Southern Medical University from May 2017 to March 2021 were divided into the control group and the observation group,with 41 cases in each group.Patients in both groups were given conventional treatments such as anti-infection and enhanced nutritional support.Patients in the control group were treated with mechanical ventilation on this basis,and patients in the observation group were treated with Ulinastatin on the basis of the control group.Patients in both groups were treated for 7 days.Compared the clinical indicators of the two groups of patients,the blood gas indicators and serum inflammatory factor levels before and after treatment,the occurrence of adverse reactions during the treatment period.Results Compared with the control group,the acute physiological and chronic health status scoreⅡ(APACHEⅡ)scores of the observation group reduced significantly,and the ventilator support,ICU hospitalization time,total hospitalization time shortened significantly;compared with before treatment,the arterial partial pressure of carbon dioxide(PaCO_(2))and serum TNF-α,IL-1β,IL-6,ICAM-1 levels of the two groups reduced significantly,and the observation group was significantly lower than the control group;after treatment,the pH value,arterial blood oxygen partial pressure(PaO2),and arterial blood oxygen saturation(SaO2)of the two groups of patients increased significantly and the observation group was significantly higher than the control group(all P<0.05);there was no statistically significant difference in the total incidence of adverse reactions between the two groups during the treatment period(P>0.05).Conclusion Ulinastatin in t
作者
尹雪霞
陈晓毅
周祥武
YIN Xuexia;CHEN Xiaoyi;ZHOU Xiangwu(Department of Internal Medicine,Baiyun Branch of Southern Hospital of Southern Medical University Guangzhou,Guangdong 510420,China)
关键词
急性呼吸窘迫综合征
乌司他丁
血气指标
炎症反应
Acute respiratory distress syndrome
Ulinastatin
Blood gas index
Inflammatory response
