乌司他丁在急性呼吸窘迫综合征的临床应用研究

Clinical Study of Ulinastatin on the Patients with Acute Respiratory Distress Syndrome

目的:观察乌司他丁(UTI)对急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)的临床应用。方法:选择我院ICU自2008年1月至2011年1月收治的160例ARDS患者作为研究对象,采用随机对照的方法,并且经患者或患者家属知情并签字同意分组。分为UTI组(A组)和对照组(B组)。两组均给予相同综合治疗措施,A组除综合治疗外还给予注射用乌司他丁,每次30万U,每日2次。分别记录两组患者开始治疗、治疗后第3天、治疗第7天的生命体征,动脉血气分析、血生化检查结果、并且记录患者在ICU治疗的转归,应用SPSS13.0软件对结果进行统计学分析。结果:经治疗3天A组呼吸频率低于B组,动脉血气分析提示两组PO2、PO2/FiO2、SaO2均有上升。比较后发现A组PO2、PO2/FiO2、SaO2高于B组(P<0.05),两组PO2、SaO2比较有统计学差异。经治疗3天A组与B组生化指标比较、白细胞计数、肾功及血乳酸均有下降,有统计学差异,P<0.05。全部治疗结束后A组与B组死亡率比较(UTI组34.29%,对照组38.26%,P=0.0097)及机械通气时间比较(UTI组7.54±3.27天,对照组11.78±2.69天,P=0.0086),均有统计学差异。结论:大剂量UTI用于ARDS的临床治疗可有效改善患者氧合指数,减少机械通气时间,降低患者的病死率。

Objective： To evaluate the clinical efficacy of ulinastatin（UTI） in the patients with acute respiratory distress syndrome（ARDS）.Methods： 160 patients suffered from ARDS in our department from January 2008 to January 2011 were selected and divided into UTI group（group A） and control group（group B）.Two groups of patients are given the same synthetical treatment.The patients from group A were received UTI 60 units intravenous in addition to the synthetical treatment.We recorded the patients’ vital signs,arterial blood gas analysis,blood biochemistry test results and outcomes respectively on starting treatment,treatment for 3 days and 7 days.SPSS 13.0 software was applied for statistical analysis of the results.Results： In group A the respiratory rate was less than the control group after treatment for 3 days;arterial blood gas analysis showed that all the patients’ PO2,PO2/FiO2,SaO2 were increased,PO2,PO2/FiO2,SaO2 of group A was higher than that of group B.PO2/FiO2,SaO2 had significant difference between the two groups after three days of treatment（P〈0.01）.The blood biochemistry test results had significant statistical difference between the two groups after three days of treatment,（P〈0.05）.The mortality rate had significant statistical difference between the two groups（group A 34.29%,group B 38.26 %,P=0.0097）after three days of treatment.The duration of mechanical ventilation had significant statistical difference between the two groups [group A 7.54±3.27 day,group B 11.78 ±2.69 day,P=0.0086] after three days of treatment.Conclusions： High-dose UTI for ARDS may improve the clinical treatment effect of oxygenation index and reduce the duration of mechanical ventilation.