早期应用乌司他丁治疗COPD机械通气患者的呼吸机相关性肺损伤

Early Application of Ulinastatin D Treatment of COPD Patients with Mechanical Ventilation, Ventilator-associated Lung Injury

目的探讨乌司他丁治疗呼吸机相关性肺损伤的临床疗效。方法选择40例呼吸机相关性肺损伤患者,随机分为乌司他丁治疗组(n=21)和对照组(n=19),两组患者均在常规积极治疗原发病的基础上采用肺保护性机械通气,乌司他丁治疗组在常规治疗基础上静脉滴注乌司他丁20万U,1次/8h,观察两组的临床疗效,血气分析指标及炎性因子水平的变化。结果治疗组与对照组在治疗前各项指标无差异。治疗后治疗组的氧合指数/呼吸指数及总有效率高于对照组(P<0.05),而IL-6,IL-8及TNF-α水平较对照组低,IL-10水平较对照组高(P<0.05)。结论乌司他丁可抑制机体炎症介质的产生,早期应用治疗效果明显。

Objective To observe the effect of Ulinastatin in the treatmen of ventilator-induced lung injury. Methods Select 40 patients with ventilator- induced lung injur patients were randomly divided into treatment group Ulinastatin （n =21） and the control group （n=19）, Ulinastatin treatment group in conventional treatment on the basis of intravenous drip Ulinastatin 200000U, every 8 hours once. To study the clinical curative effect of two groups, specific observed before and after treatment the oxygenation index, APACHE 11 and the concentration of IL-6, IL-8, IL-10 and TNF-α. Results Ulinastatin treatment group and control group before therapy each index compared with control group no difference. After the treatment of Ulinastatin treatment group IL-6, IL-8 and TNF-α level was lower than the control group （P〈0.05）.The level of IL-10 in treatment group was higher than the control group （P〈0.05）. The APACHE 11, clinical curative effect and oxygenation in the treatment group were better than the control group（P〈0.05）. Conclusion Ulinastatin can suppress the inflammation of generation,acute lung injury early treatment has obvious effect.