乌司他丁联合大黄胶囊治疗急性肺损伤/急性呼吸窘迫综合征疗效观察

Therapeutic effect of combination rhubarb capsule and ulinastatin on acute lung injury/acute respiratory dis- tress syndrome

目的观察乌司他丁(UTI)联合大黄胶囊治疗急性肺损伤/急性呼吸窘迫综合征(ALI/ARDS)的疗效。方法58例ALL/ARDS患者随机分为对照组27例和治疗组31例,观察2组患者治疗前后肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、D-二聚体及血气分析、呼吸频率(RR)、平均动脉压(MAP)的变化,记录住院时间、住ICU时间、机械通气时间及死亡例数。结果2组患者治疗后TNF-α、IL-1β含量和观察组D-二聚体含量均较治疗前有明显下降(P<0.05),且2组患者治疗后比较差异均有统计学意义(P<0.01)。2组RR减慢、MAP下降,动脉血氧分压(PaO_2)、血氧饱和度(SaO_2)明显上升,与治疗前比较差异有统计学意义(P<0.01),且治疗组明显优于对照组(P<0.01,P<0.05)。治疗组住院时间、住ICU时间、机械通气时间较对照组明显缩短(P<0.05),病死率差异无统计学意义(P>0.05)。结论UTI与大黄胶囊联合应用可显著抑制机体炎性介质的产生,从而减轻炎性反应对机体的损伤,改善ALI/ARDS的预后。

Objective To investigate the therapeutic effects of combination ulinastatin and rhubarb capsule on acute lung injury/acute respiratory distress syndrome（ALI/ARDS）.Methods Fifty-eight patients with ALI/ ARDS were randomly divided into control group（27 cases）and treatment group（combination ulinastatin and rhubarb capsule,31 cases）.Tumor necrosis factor（TNF-α）,IL-1β,D-dimmer,respiratory rate（R R）,oxygenation,average arterial blood pressure changes were compared before and after treatment.The mechanical ventilation time,mortality were recored in both two groups before and after treatment.Results After treatment,the TNF-α,IL-1βand D-dimer were decreased significantly in both two groups（P〈0.05）,and those indexes were more obviously in treatment group than control group（P〈0.01）.Both groups as well as the respiratory rate,and the average arterial blood pressure,PaO2 and SaO2 increased significantly compared with before treatment（P〈0.01 or P〈0.05）,and the effective was more obviously in treatment group than control group（P〈0.05）.Mechanical ventilation time,the time in hospital and in ICU were significantly shorter than in the control group,the difference was statistically significant （P〈0.05）.Conclusion It suggested that combination ulinastatin and rhubarb could significantly inhibit the production of inflammatory cytokines,and thus prevent the systemic injury by inflammatory response and improve the prognosis of ALI/ARDS.