乌司他丁联合血必净治疗老年重症肺炎的临床研究

The Clinical Study of Ulinastatin and Xuebijing on Elderly Patients with Severe Pneumonia

目的:探讨乌司他丁联合血必净治疗老年重症肺炎的疗效。方法:将160例老年重症肺炎患者随机分为对照组(A组)、乌司他丁组(B组)、血必净组(C组)、乌司他丁+血必净联合组(D组)各40例,A组予常规治疗,B组、C组、D组在A组基础上分别给予静脉滴注乌司他丁、血必净、乌司他丁和血必净7 d。比较各组治疗前后血浆肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、降钙素原(PCT)水平、动脉血气分析,抗生素使用时间、机械通气时间、ICU住院时间和28d生存率。结果:D组治疗后TNF-α、IL-6、PCT显著下降,PaO_2、PaO_2/FiO_2升高程度及P(A-a)O_2下降幅度明显大于其他三组;抗生素使用时间、机械通气时间、ICU住院时间明显少于其他三组,28 d生存率则明显高于其他三组,P均<0.05。结论:乌司他丁联合血必净辅助治疗老年重症肺炎疗效显著。

Objective： To explore the therapeutic effects of Ulinastatin and Xuebijing on elderly patients with severe pneumonia. Methods： 160 elderly patients with severe pneumonia were randomly divided into control group （group A）, Ulinastatin group （group B）, Xuebijing group （group C） and combined group （group D）. The group A was given routine treatment. On the basis of group A, the group B was given Ulinastatin, the group C was given Xuebijing, the group D was given Ulinastatin and Xuebijing for 7 days. Before treatment and on 8th day from the beginning, blood concentrations of TNF-α, IL-6, PCT were detected, while PaO2, PaO2/FiO2, P（A-a）O2 of blood gas analysis were monitored, and the times of antibiotic used , mechanical ventilation, in ICU and the 28-day survival rate were compared among the four groups. Results： TNF-α,IL-6,PCT,P（A-a）O2 in all groups decreased after treatment, and the descending degree in group D was significantly obvious than those in the other groups. PaO2, PaO2/FiO2 in all the groups increased after treatment, and the increasing degree in group D was more obvious than those in the other groups o The times of antibiotic used, mechanical ventilation and the days in ICU on group D were significantly shorter than those in the other groups , but the 28-day survival rate was significantly higher than that in the other groups, all P〈0.05. Conclnsions：The treatment of Ulinastatin combined with Xuebijing has significant therapeutic effects on elderly patients with severe pneumonia.