摘要
目的探讨乌司他丁联合参麦注射液治疗对重症肺炎患者心肌损伤保护及肺功能的影响。方法将120例重症肺炎患者随机分为对照组和观察组,每组各60例,对照组给予参麦注射液治疗,观察组在对照组的基础上给予乌司他丁治疗,连续治疗2周。比较两组临床疗效、炎性因子、心肌指标、血气指标及APACHE⁃Ⅱ评分。结果治疗后观察组总有效率高于对照组(P<0.05)。相较于治疗前,两组患者治疗后FEV1%、FEV1/FVC均升高,且观察组治疗后FEV1/FVC高于对照组(均P<0.05),但两组治疗后FEV1%比较,差异无统计学意义(P>0.05);治疗后两组患者炎性相关指标TNF⁃α、CRP、PCT低于治疗前,且观察组低于对照组(均P<0.05);治疗后两组患者心肌损伤相关指标CK⁃MB、LDH、α⁃HBDE及NT⁃proBNP、cTnⅠ水平低于治疗前,且观察组低于对照组(均P<0.05);治疗后两组患者PaO2、SaO2及OI高于治疗前,观察组高于对照组(均P<0.05);治疗后两组APACHEⅡ评分低于治疗前,且观察组低于对照组(均P<0.05);观察组患者血管疼痛、腹泻、皮肤瘙痒等不良反应发生率明显低于对照组(均P<0.05)。结论参麦注射液联合乌司他丁可更明显地减轻重症肺炎患者肺部炎症状态,改善患者血气,保护受损的心肌,疗效好,不良反应少。
Objective To investigate the effect of ulinastatin combined with Shenmai Injection on myocar⁃dial injury protection and pulmonary function in patients with severe pneumonia.Methods One hundred and twenty patients with severe pneumonia were randomly divided into control group and observation group,with 60 cases in each group.The control group was treated with Shenmai injection,and the observation group was treated with ulina⁃statinand for Shenmai injection 2 consecutive weeks.The clinical efficacy,inflammatory factors,myocardial indexes,blood gas indexes and Apache⁃Ⅱscore were compared between the two groups.Results After treatment,the total effective rate of the observation group was higher than that of the control group(P<0.05).Compared with those before treatment,FEV1%and FEV1/FVC in the two groups increased after treatment,and FEV1/FVC in the observation group was higher than that in the control group(all P<0.05),but there was no significant difference between the two groups(P>0.05).After treatment,TNF⁃α,CRP and PCT were reduced in the two groups,which were lower in the observation group than those in the control group(P<0.05);CK⁃MB,LDH,α⁃HBDE,NT⁃proBNP and cTnⅠin the observation group were lower than those in the control group(all P<0.05);PaO2,SaO2 and OI in the two groups were higher than those before treatment,which were higher in the observation group(all P<0.05);the ApacheⅡscore of the two groups was lower than that before treatment,and that of the observation group was lower than that of the control group(all P<0.05).The incidence of adverse reactions such as vascular pain,diarrhea and skin pruritus in the observation group was significantly lower than that in the control group(all P<0.05).Conclusion Shenmai injection combined with ulinastatin can significantly reduce the pulmonary inflammatory state of patients with severe pneumonia,improve blood gas and protect damaged myocardium.It has good curative effect and less adverse reactions.
作者
谢辉
冯俊
黄秋杰
王均祎
叶汶
XIE Hui;FENG Jun;HUANG Qiujie;WANG Junyi;YE Wen(Department of Critical Care Medicine,Nanping First Hospital Affiliated to Fujian Medical University,Nanping 353000,China)
出处
《实用医学杂志》
CAS
北大核心
2022年第10期1260-1264,共5页
The Journal of Practical Medicine
关键词
重症肺炎
乌司他丁
参麦注射液
炎症因子
心肌保护
血气
severe pneumonia
ulinastatin
Shenmai Injection
inflammatory factors
myocardial protection
blood gas
