血必净与乌司他丁配伍治疗重症肺炎237例

Clinical study of Xuebijing injection and Ulinastatin on severe pneumonia treatment

目的:探讨血必净与乌司他丁配伍治疗重症肺炎的临床疗效。方法:将237例重症肺炎患者随机分为对照组、血必净组、乌司他丁组及血必净+乌司他丁联合治疗组,并于治疗前、治疗后1周、2周分别测定纤支镜肺灌洗液中蛋白含量/血浆蛋白、中性粒细胞数目(N)及炎症因子IL-6浓度,监测血气分析氧分压、肺泡-动脉氧分压差,测定肺顺应性变化,评估肺功能恢复情况。结果:四组患者治疗两周后纤支镜肺灌洗液中IL-6分别为159.3±11.4ng/L,143.1±9.9ng/L,139.1±7.8ng/L,125.7±11.8ng/L;中性粒细胞数目分别为9.4±0.9,8.9±0.8,8.3±0.5,7.9±0.8;白蛋白含量/血浆白蛋白分别为0.72±0.06,0.66±0.05,0.59±0.03,0.51±0.06;肺顺应性分别为199.89±12.79,203.99±12.88,205.87±11.97,213.85±11.19;血气分析氧分压分别为105.3±14.5,101.3±5.7,107.9±4.9,115.3±11.9;肺泡-动脉氧分压差分别为13.8±3.1,15.3±3.5,13.1±4.7,10.1±1.9。四组患者组内相比,肺灌洗液中IL-6,中性粒细胞、白蛋白含量/血浆白蛋白、肺泡-动脉氧分压差均显著下降(P<0.05),肺顺应性、血氧分压均明显升高(P<0.05)。提示肺功能明显改善,但以联合治疗组效果最好(P<0.05)。结论:血必净联合乌司他丁治疗重症肺炎,能够强效抗感染、改善机体氧和、降低毛细血管通透性。

Objective： To observe the clinical therapeutic efficiency of Xuebijing injection and Ulinastatin on severe pneumonia treatment. Methods..237 cases were randomized into control group, Xuebijing group, Ulinasta- tin group, Xuebijing and Ulinastatin combination group. It＇s detected the protein content/ plasma proteins of bron- choalveolar lavage fluid （BALF）, neutrophils numbers and inflammatory factor 1L-6 concentration , also monitored PaO2 and P（A-a）O2 of blood gas analysis , pulmonary compliance changes by end-tidal airway occlusion technique before and after 1,2 weeks in the experiment,for the lung function recoverd evaluation. Results： Four groups of pa- tients bronchoscopy lung lavage fluid IL-6 after 2 weeks of treatment were 159.3±11.4 ng / L, 143.1 ± 9.9 ng/L, 139.1±7.8ng/L, 125.7.±11.8ng/L, neutral Granular celi numbers were 9.4±0.9,8.9±0.8,8.3±0.5,7.9±0. 8, albumin concentration / serum albumin were 0. 72±0. 06, 0.66±0.05, 0. 59±0. 03,0. 51±0. 06, lung compli- anceas 199.89±12.79,203.99±12.88,205.87±11.97,213.85±11.19, blood gas analysis of oxygen partial pres- sure were 105.3±14.5,101.3±5.7,107.9±4.9,115.3±1.9, alveolar - arterial oxygen difference were 13.8±3. 1,15.3±3.5, 13.1±4.7, 10.1±1.9. Four groups of patients was compared in lung lavage fluid IL-6, neutrophil ceils, albumin concentration / serum albumin, alveolar - arterial oxygen difference were significantly decreased （P 〈0.05）, lung compliance, blood oxygen partial pressure were significantly higher （P 〈0.05）, and prompted lung function improved significantly, but the best effect to the combination therapy group. Conclusion.. The combination group is more effective in the treatment of severe pneumonia,and the causes are relevant to potent anti-infection,the body oxygen improvement and capillary permeability reduction.