摘要
目的分析乌司他丁联合连续血液净化(CBP)对脓毒症急性肺损伤(ALI)患者肺功能、基质金属蛋白酶/基质金属蛋白酶组织抑制剂(MMPs/TIMPs)水平的影响。方法选取我院收治的80例脓毒症ALI患者为研究对象,按入院先后顺序将其分为对照组和研究组,每组40例。对照组给予CBP治疗,研究组给予乌司他丁联合CBP治疗。比较两组的治疗效果。结果治疗后,两组的用力肺活量(FVC)、氧合指数(OI)、静态肺顺应性(Cst)均显著升高,且研究组高于对照组(P<0.05)。治疗后,两组的基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶组织抑制剂-1(TIMP-1)、基质金属蛋白酶组织抑制剂-2(TIMP-2)水平均显著降低,且研究组低于对照组(P<0.05)。治疗后,研究组的谷胱甘肽过氧化物酶(GSH-Px)水平高于对照组,单胺氧化酶(MAO)、可溶性髓样细胞触发受体转录因子-1(sTLT-1)、高迁移率族蛋白B1(HMGB-1)水平低于对照组(P<0.05)。治疗后,两组的白细胞分化抗原3阳性(CD3^(+))、白细胞分化抗原4阳性(CD4^(+))、白细胞分化抗原4阳性/白细胞分化抗原8阳性(CD4^(+)/CD8^(+))均升高,CD8^(+)降低,且研究组优于对照组(P<0.05)。结论乌司他丁联合CBP治疗脓毒症ALI能够调节MMPs/TIMPs水平、血清指标及改善免疫功能,促进肺功能恢复。
Objective To analyze the effects of ulinastatin combined with continuous blood purification(CBP)on lung function and matrix metalloproteinase/tissue inhibitors of metalloproteinase(MMPs/TIMPs)level in patients with acute lung injury(ALI)caused by sepsis.Methods Eighty patients with ALI caused by sepsis admitted in our hospital were selected as the study objects and divided into control group and study group according to the order of admission,with 40 cases in each group.The control group was treated with CBP,and the study group was treated with ulinastatin combined with CBP.The therapeutic effects of the two groups were compared.Results After treatment,forced vital capacity(FVC),oxygenation index(OI)and static lung compliance(Cst)in both groups significantly increased,and those in the study group were higher than the control group(P<0.05).After treatment,the levels of matrix metalloproteinase-2(MMP-2),matrix metalloproteinase-9(MMP-9),tissue inhibitor of metalloproteinase-1(TIMP-1)and tissue inhibitor of metalloproteinase-2(TIMP-2)in both groups significantly decreased,and those in the study group were lower than the control group(P<0.05).After treatment,the level of glutathione peroxidose(GSH-Px)in the study group was higher than that in the control group,while the levels of monoamine oxidase(MAO),soluble triggering receptor expressed on myeloid cells-like transcript-1(sTLT-1)and high mobility group box-1(HMGB-1)were lower than those in the study group(P<0.05).After treatment,cluster of differentiation 3 positive(CD3^(+)),cluster of differentiation 4 positive(CD4^(+)),cluster of differentiation 4 positive/cluster of differentiation 8 positive(CD4^(+)/CD8^(+))in both groups increased,CD8^(+)decreased,and those in the study group were better than the control group(P<0.05).Conclusion Ulinastatin combined with CBP in the treatment of ALI caused by sepsis can regulate the MMPs/TIMPs level,serum indexes and improve immune function,and promote the recovery of lung function.
作者
付淼
陈光
FU Miao;CHEN Guang(Emergency Department,Baoji Central Hospital,Baoji 721000,China)
出处
《临床医学研究与实践》
2023年第32期45-48,共4页
Clinical Research and Practice
关键词
乌司他丁
连续血液净化
脓毒症
急性肺损伤
ulinastatin
continuous blood purification
sepsis
acute lung injury
