乌司他丁对重症手足口病患儿的肺保护作用

The Lung Protection Effect of Ulinastatin in Patients with Severe Hand-Foot-Mouth Disease

目的:探讨乌司他丁辅助治疗重症手足口病对患儿的肺保护作用。方法:选取2010年1月至2012年3月在我院ICU住院治疗的重症手足口病患儿60例,随机分为对照组29例和治疗组31例。对照组给予机械通气为主的综合治疗,治疗组在对照组治疗基础上予乌司他丁静脉注射,10 000 U/kg加入0.9%氯化钠注射液20 mL微量泵注射,1 h内注入,每12 h 1次,连用7d。比较两组患儿治疗前后的氧合指数(OI)、呼吸指数(RI)及血清IL-6、IL-10、TNF-α、CK-MB水平,比较两组患儿治疗前后PCIS评分及机械通气时间和ICU住院时间。结果:治疗后两组患儿氧合指数及呼吸指数均好转,但治疗组呼吸指数及氧合指数优于对照组(P<0.05);治疗后两组患儿血清IL-6、IL-10及TNF-α水平均不同程度降低,而治疗组水平下降更明显(P<0.05);治疗后两组患儿PCIS评分均升高,而治疗组高于对照组(P<0.05);治疗组机械通气时间短于对照组(P<0.05);两组患儿住院时间比较差异无统计学意义(P>0.05)。结论:乌司他丁辅助治疗重症手足口病,可改善血气指标,保护心肺功能,提高治疗效果,值得临床推广应用。

Objective： To study the lung protection effect of ulinastatin（UTI） in patients with severe hand-foot-mouth disease（HFMD）.Methods： A total of 60 patients with severe HFMD from Jan 2010 to Mar 2012 were randomly divided into the treatment group（n=31） and the control group（n=29）.All the cases in the two groups received routine treatment（included mechanical ventilation）,while those in treatment group were additionally treated with 10,000 U/kg ulinastatin intravenously every 12 hours for 7 days.The levels of IL-6,TNF-α,IL-10,CK-MB,OI and RI values and the pediatric critical illness score（PCIS） were detected before treatment and on the 7th day after treatment.The hospitalization time and mechanical ventilation time were studied.Results： After treatment,the levels of IL-6,TNF-α,IL-10,OI,RI and CK-MB in the treatment group were reduced significantly than those in the control group（P〈0.05）.The levels of PCIS in the treatment group were increased significantly than those in the control group（P〈0.05）.No statistically significant difference was found in hospitalization time between the two groups（P〉0.05）.The mechanical ventilation time in the treatment group were lower than that in the control group（P〈0.05）.Conclusions： Ulinastatin are efficient in treatment of patients with severe HFMD.