北京大学学报（医学版）2016，Vol.48Issue(4)：672-679,8.DOI:10.3969/j.issn.1671-167X.2016.04.021
乌司他丁在预防急性呼吸窘迫综合征中的作用
Preventive effects of ulinastatin on acute respiratory distress syndrome
摘要
Abstract
Objective:To explore the effect of ulinastatin on prevention of acute respiratory distress syn-drome (ARDS).Methods:A prospective multicentral cohort study was conducted.The patients from three intensive care units (ICUs)of grade A tertiary hospitals in Beijing and a ICU of grade A tertiary hospitals in Cangzhou from January 2012 to December 2014,included 77 ARDS at-risk patients with uli-nastatin treatment and 108 ARDS at-risk patients without ulinastatin treatment (control)were eligible. Both groups received normal treatment;additionally,the intervention group received 600 000 units of uli-nastatin via intravenous infusion for 5 days.The control group received the same amount of saline via in-travenous infusion for 5 days.Venous blood human neutrophil elastase (HNE)and peptidase inhibitor 3 (PI3)levels were measured on days 1,3,and 7,respectively.Other outcomes included acute physiolo-gy and chronic health evaluation scoring Ⅱ (APACHE Ⅱ),body temperature,respiratory rate,heart rate,mean arterial pressure,white blood cell counts,PaO2 /FiO2 ,ARDS incident,mechanical ventila-tion time,ICU treatment and hospitalization duration,28 days mortality.Results:The PI3 levels showed no statistical difference on day 1,but significant differences on day 3 and day 7 between the two groups (P <0.01).HNE /PI3 ratio showed no statistical difference on day 1,but significant differences on day 3 and day 7 (P <0.05).PaO2 /FiO2 was significantly higher in ulinastatin group on day 3 and day 7 (P <0.05).The incident rate for ulinastatin group was 15.58%,lower than that for the control group (33.33%),and the difference was statistically significant (P <0.05).The mechanical ventilation time and ICU treatment time in ulinastatin group was shorter than that in the control group,and the difference was statistically significant (P <0.05).There were no significant effects in other factors.Conclusion:Increased dose of ulinastatin can recover the balance of HNE and its antagonist,lower the HNE’s damage to lungs,and further reduce the ARDS incident rate.关键词
乌司他丁/呼吸窘迫综合征,成人/白细胞弹性蛋白酶Key words
Ulinastatin/Respiratory distress syndrome,adult/Leukocyte elastase分类
医药卫生引用本文复制引用
贾丽静,易亮,杨志旭,王书鹏,李刚,朱曦..乌司他丁在预防急性呼吸窘迫综合征中的作用[J].北京大学学报（医学版）,2016,48(4):672-679,8.基金项目
国家自然科学基金（81372043）、首都医学发展科研基金（2009-1014）、北京市自然科学基金（7162199）、天普研究基金（01201113）资助 Supported by the National Natural Science Foundation of China （81372043），the Capital Medical Development and Scientific Research Fund （2009-1014），Beijing Natural Science Foundation （7162199），and Techpool Research Fund （）
