美洲大蠊提取物对急性肺损伤/急性呼吸窘迫综合征患者应激性溃疡出血的预防作用

Preventive Effect of Periplaneta Americana Extract on Stress Ulcer Bleeding in Patients with Acute Lung Injury or Acute Respiratory Distress Syndrome

目的探讨美洲大蠊提取物对急性肺损伤/急性呼吸窘迫综合征(ALI/ARDS)患者应激性溃疡出血的预防作用。方法选取2009年1月—2010年1月我院中心ICU住院的严重创伤后ALI/ARDS患者64例为研究对象,随机数字表法分为治疗组和对照组,各32例,对照组给予积极常规综合治疗,治疗组在常规综合治疗基础上,于入院当天给予美洲大蠊提取物康复新液预防应激性溃疡出血,经胃管注入,10 ml/次,3次/d,连用7 d。分别于给药前及给药第7天,测定胃液pH值,测定氧分压,计算氧合指数(PaO2/FiO2);同时记录两组应激性溃疡出血发生率及病死率。结果治疗前,两组患者胃液pH值、PaO2/FiO2比较,差异均无统计学意义(P>0.05);治疗后,两组患者胃液pH值、PaO2/FiO2比较,差异均有统计学意义(P<0.05)。两组患者应激性溃疡出血发生率比较,差异有统计学意义(P<0.05);两组患者病死率比较,差异无统计学意义(P>0.05)。结论美洲大蠊提取物可改善ALI/ARDS患者胃液pH值、PaO2/FiO2,对应激性溃疡出血有预防作用。

Objective To study the preventive effect of periplaneta americana extract on stress ulcer bleeding in patients with acute lung injury and acute respiratory distress syndrome.Methods 64 in-patients with acute lung injury（ALI） or acute respiratory distress syndrome（ARDS） hospitalized in ICU from January 2009 to January 2010 were randomly divided into treatment group and control group with each group 32 cases.The control group was given positive routine treatment,while the treatment group was given periplaneta americana extract on the admission day to prevent stress ulcer bleeding in addition to routine treatment.The periplaneta americana extract was injected via gastronomy tube by 10 ml per time for seven consecutive days with each day three times.The pH value of gastric juice and oxygen partial pressure were detected before treatment and seven days after treatment and the value of PaO2/FiO2 was also calculated.Meanwhile,the incidence of stress ulcer bleeding and mortality of the two groups were recorded.Results Before treatment,the pH value of gastric juice and PaO2/FiO2 value showed no statistically significant differences between the two groups（P0.05）.After treatment,the pH value of gastric juice and PaO2/FiO2 value showed statistically significant differences between the two groups（P0.05）.The incidence of stress ulcer bleeding between the two groups showed statistically significant difference（P0.05）,but the mortality did not（P0.05）.Conclusion The periplaneta americana extract plays a positive role in improving the pH value of gastric juice and PaO2/FiO2 value among patients with ALI/ARDS.It also has preventive effect on stress ulcer bleeding.