摘要
目的探讨中性粒细胞弹性蛋白酶(NE)抑制剂西维来司他钠在重症监护室(ICU)急性肺损伤(ALI)患者中应用的有效性和安全性。方法回顾性分析2020年6月至2021年6月郑州大学第一附属医院ICU 171例ALI患者,其中西维来司他钠组77例,常规治疗组94例。收集患者的临床资料,包括急性生理和慢性健康评分Ⅱ(APACHEⅡ)、Murray肺损伤评分、氧合指数(PaO2/FiO2)、炎症因子(IL-6、IL-10、TNF-α),并统计无呼吸机天数(VFD)、ICU住院天数及28 d病死率等,来评估西维来司他钠对ICU中ALI治疗的有效性。同时,记录西维来司他钠使用后30 d内患者不良反应及化验指标来评估其应用的安全性。结果与常规治疗相比,西维来司他钠治疗7 d后氧合指数、Murray肺损伤评分、IL-6、IL-10、TNF-α均明显改善,差异有统计学意义。与常规治疗组相比,西维来司他钠组VFD更长(P=0.0119),ICU住院天数更少(P=0.0269),差异具有统计学意义。西维来司他钠组病死率为14.29%,常规治疗组病死率为22.34%,两组间病死率差异无统计学意义。西维来司他钠使用后30 d内未增加患者不良反应,安全性良好。结论重症监护室急性肺损伤患者使用西维来司他钠治疗安全性良好,较常规治疗更有效。
Objective To explore the efficacy and safety of sivelestat,a neutrophil elastase(NE)inhibitor,in the treatment of acute lung injury(ALI)in the intensive care unit(ICU).Methods A retrospective analysis was performed on 171 patients with ALI in the ICU of the First Affiliated Hospital of Zhengzhou University from June 2020 to June 2021,including 77 patients in the sivelestat group and 94 patients in the conventional treatment group.Acute physiology and chronic health evaluation(APACHE)Ⅱscore,Murray lung injury score,oxygenation index(PaO2/FiO2 ratio),inflammatory cytokines(IL-6,IL-10,TNF-α),ventilator-free days(VFD),the length of ICU stay,and the 28-day mortality were collected to assess the efficacy of sivelestat.At the same time,adverse reactions and laboratory test results within 30 days after the use of sivelestat were recorded to assess the safety.Results Compared with conventional treatment,oxygenation index,Murray lung injury scores,IL-6,IL-10,and TNF-αwere significantly improved after 7 days of sivelestat treatment.Compared with the conventional treatment group,the VFD was significantly longer(P=0.0119)and the length of ICU stay was significantly shorter(P=0.0269)in the sivelestat group.The mortality was 14.29%in the sivelestat group and 22.34%in the conventional treatment group and,with no statistically significant.In the meantime,sivelestat did not increase adverse reactions within 30 days after treatment.Conclusions Sivelestat treatment is safe and more effective than conventional treatment for ALI patients in the ICU.
作者
谷玉雷
肖莉丽
裴辉
徐东
姜毓敏
谢佳丰
张晓凡
毛宇径
朱志强
Gu Yulei;Xiao Lili;Pei Hui;Xu Dong;Jiang Yumin;Xie Jiafeng;Zhang Xiaofan;Mao Yujing;Zhu Zhiqiang(EICU,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;CCU,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2022年第8期1061-1065,共5页
Chinese Journal of Emergency Medicine
基金
河南省科技攻关项目(222102310505)
河南省高等学校重点项目(225320052)
河南省医学科技攻关项目(SBGJ202103066)。
