中国临床药理学杂志2016，Vol.32Issue(14)：1268-1271,4.DOI:10.13699/j.cnki.1001-6821.2016.14.006
乌司他丁联合无创通气治疗急性呼吸窘迫综合征的临床研究
Clinical trial of ulinastatin combined with mechanical ventilation in patients with acute respiratory distress syndrome
摘要
Abstract
Objective To observe the clinical efficacy and prognosis of ulinastatin combined with mechanical ventilation in patients with acute respiratory distress syndrome ( ADRS).Methods Seventy-six patients were randomly divided into treatment group and control group , with 38 cases in each group .Control group was treated with mechanical ventila-tion.Treatment group was given ulinastatin 600 ,000 U, qd on the basis of control group.The course of treatment was 1 week.The clinical effica-cy, hospital stay time , mechanical ventilation , acute lung injury score , and treatment of inflammatory cytokines , blood gas index of the two groups were compared before treatment and after treatment . Results After treatment, total effective rate in treatment group was 92.11% ( 35/38 ) , significantly higher than 73.68% in control group (28/38, P<0.05).Interleukin ( IL) -6, IL-1β, and tumor necrosis factor -α( TNF-α) in treatment group were ( 105.54 ±21.34 ) , ( 0.54 ±0.05 ) , ( 8.25 ±1.21 ) ng・ L-1 , significantly lower than ( 182.02 ±25.87 ) , (2.21 ±0.57), (15.87 ±1.87) ng・ L-1 in control group (P<0.05).In treatment group, arterial oxygen saturation (SaO2) (93.15 ±12.35)%, partial pressure of carbon dioxide(PaCO2) (40.25 ±5.47) mmHg, pressure of arterial oxygen ( PaO2 ) ( 80.13 ±6.87 ) mmHg and partial pressure of oxygen/fraction of inspiration ( PaO2/FiO2 ) (351.47 ±25.47) were significantly higher than (84.22 ±11.47) %, (34.18 ±3.87) mmHg, (68.54 ±5.57) mmHg and (261.24 ±15.47 ) in control group (P<0.05).Hospitalization time and mechanical ventilation time of treatment group were ( 13.87 ±3.21 ), ( 10.25 ±2.01 ) d, significantly shorter than ( 18.24 ±4.35 ), (14.24 ±2.54) d in control group(P<0.05).The main adverse drug reactions manifested as diarrhea , rash, nausea and vomiting , with no significant difference of incidence of adverse reactions in two group ( P >0.05 ) . Conclusion Ulinastatin combined with noninvasive mechanical ventilation in the treatment of ARDS patients , could significantly decrease the levels of IL -6, IL-1βand TNF-α, improve patients’ oxygenation index, and shorten the duration of mechanical ventilation .关键词
乌司他丁/无创机械通气/急性呼吸窘迫综合征/炎症因子Key words
ulinastatin/mechanical ventilation/acute respiratory distress syndrome/inflammatory factor分类
药学引用本文复制引用
黄庆生,张丽霞,李燕,郭建英,张华伟,方明星,吴春涛,王智勇..乌司他丁联合无创通气治疗急性呼吸窘迫综合征的临床研究[J].中国临床药理学杂志,2016,32(14):1268-1271,4.基金项目
河北省卫生厅课题基金资助项目 （）
