乌司他丁对重症急性胰腺炎肺损伤的保护作用

Protective Effect of Ulinastatin on Severe Acute Pancreatitis Patients Complicating with Acute Lung Injury

【目的】探讨乌司他丁对重症急性胰腺炎（SAP）急性肺损伤（ALI）的保护作用。【方法】46例SAP患者随机分为乌司他丁治疗组和对照组，每组23例，对照组给予常规治疗，治疗组则在常规治疗基础上加用乌司他丁治疗。分别于治疗前、治疗后的d7、d14分析患者动脉血气，以呼吸频率（RR）、氧合指数（PaO／FiO2）二氧化碳分压（PaCO2）、胸片变化及预后等为观测指标，观察乌司他丁治疗组与对照组之间肺损伤发生率差异以及对肺损伤的疗效。【结果】治疗组SAP肺损伤的发生率为21．1％，对照组为55．6％，两组比较差异有统计学意义（P〈0．05）；治疗后d7、d14乌司他丁治疗组肺损伤程度指标RR、PaO／FiO2、PaCO2及胸片评分较对照组明显改善，差异有统计学意义（P〈0．05），尤其以d7最为显著（P〈0．01）。【结论】乌司他丁对SAP引起的ALI有预防和治疗作用，可以显著减少SAP引起的ALI的发生，并能促进SAP的好转。

[Ohjective] To study the protective effect of ulinastatin（UST） on severe acute pancreatitis （SAP） patients complicating with acute lung injury（ALI）. [Methods]Forty six patients with SAP were divided into therapy group and control group. Twenty three patients in control group were treated with conventional treatment, and 23 patients in therapy group were treated with conventional treatment combined with UST. The differences of the incidence of lung injury and curative effect on lung injury between two groups were analyzed by monitoring respiratory rate （RR）, oxygenation index （PaO/FiO2 ）, PaCO2 and chest X ray examination. [Results]The incidence of ALI/ARDS was 21.1% in UST therapy group and 55.6% in control group. There was significant difference between two groups（ P 〈0.05）. Compared with control group, the severity of lung injury had been lessened significantly in therapy group （ P 〈0.01）. [Conclusion] UST can reduce the ineidence of ALI in the patients with SAP and improve the recovery of ALI. UST has significantly preventive and therapeutic effects on ALI in SAP patients.