乌司他丁治疗免疫功能降低并发急性间质性肺炎的疗效

Curative effects of ulinastatin on patients with immune function decline complicated with acute interstitial pneumonia

目的探讨乌司他丁(UTI)对免疫功能降低并发急性间质性肺炎患者的疗效及安全性。方法将15例长期服用强的松片或免疫抑制剂合并间质性肺炎患者,随机分成治疗组(n=8例)和对照组(n=7例),治疗组每日加用乌司他丁20万U静脉推注,4次/d;对照组则采用相同剂量盐水推注,4次/d。两组均治疗2 w,观察患者治疗前后胸部CT、C反应蛋白(CRP)、氧合指数等相关指标,并随访患者28 d及90 d病死率。结果两组治疗2 w后,患者总体情况较治疗前都有改善,治疗组与对照组对比,胸部CT有改善,氧合指数、APACHEⅡ等改善情况较对照组明显(P<0.05);两组28 d和90 d病死率虽无统计学差异(分别为0.268和0.185),但治疗组病死率低于对照组。结论乌司他丁治疗免疫力降低患者间质性肺炎安全有效,但能否改善患者预后,还需进一步研究。

Objective To discuss the curative effects of ulinastatin （ UTI ） on patients with immune function decline complicated with acute interstitial pneumonia （ AIP ） and its safety. Methods Fifteen patients with interstitial pneumonia who took prednisone pills or immnnosuppressor for a long term were randomly divided into treatment group（ n = 8 ）and control group（ n = 7 ）. The treatment group received the additional use of intravenous injection with 200,000 U ulinastatin 4 times per day, while the control group received the injection with the same dosage of saline water 4 times a day. The course of treatment for both groups was 2 weeks. Then observation was made in relevant indexes such as chest CT, CRP, oxygenation index of patients before and after the treatment. The follow-up was made to study the patients＂ mortality 28 days and 90 days after the treatment. Results After the two-week treatment, the general condition of those patients was all improved. Compared with the conditions of the control group, the chest CT, oxygenation index, and APACHE II of the treatment group were better（ P 〈 0.05 ）. Although there was no significant difference in the mortality rate 28 days and 90 days after the treatment between the two groups, but the mortality rate of the treatment group was lower than that of the control group（ P was 0. 268 and 0. 185, respectively ）. Conclusion Ulinastatin has safe effect on patients with immune function decline complicated with AIP. But whether it can improve patients＇prognosis needs further research to verify.