乌司他丁佐治吸入性肺炎高龄男性患者的临床评价

Clinical evaluation of ulinastatin in the treatment of aspiration pneumonia in elderly male patients

目的观察乌司他丁佐治吸入性肺炎高龄男性患者的临床疗效和安全性,为临床治疗提供依据。方法将2013年1月至2014年6月在我院干诊科住院的46例高龄男性吸入性肺炎患者随机分为两组。其中,治疗组26例,对照组20例。两组患者均接受常规抗炎、化痰及营养支持治疗;治疗组另予乌司他丁20 wu/d,疗程7 d。观察并记录两组患者每日的最高体温(T)、心率(HR)、呼吸(RR)、脉搏血氧饱和度(Sp O2)、动脉血氧分压(Pa O2)、氧合指数(Pa O2/Fi O2)及治疗前及治疗后3 d、7 d的白细胞计数(WBC)、降钙素原(PCT)、超敏C-反应蛋白(hs-CRP),定期检查肝肾功能、胸片、痰培养+药敏,并按疗效及安全性标准判定治疗结果。结果两组患者治疗后症状及各指标均改善,但治疗组疗效显效率优于对照组(65.3%:50%,P<0.05),治疗3 d后治疗组患者T、HR、RR、WBC、Sp O2、PCT、hs-CRP及氧合指数指标恢复情况均优于对照组(P<0.05)。两组患者均无不良事件发生。结论乌司他丁能有效改善吸入性肺炎高龄男性患者的病情,减轻肺损伤,改善预后,对其救治具有重要的临床意义。

Objective To observe the effect of ulinastatin on aspiration pneumonia in elderly male patients. Methods A total of 46 male aspiration pneumonia with age over 75-year-old admitted in our department from January 2013 to June 2014 were enrolled in this study. In all 46 patients, 26 cases were randomly assigned as observation group （ ulinastatin group ）, and the other 20 cases served as control group. Patients in both groups were given routine treatment, while the patients of ulinastatin group were given ulinastatin （200 000 U, micro pump 1/24 hours,7 days） in addition. The improvement condition by monitoring temperature （T）, heart rate （ HR）, respirature rate （ RR）, pulse blood oxygen saturation （ SpO2 ）, white blood cell （ WBC ）, procaleimnin （ PCT ）, high-sensitivity C-reactive protein（hs-CRP） and oxygenation index（ PaOE/FiO2 ） were observed. Results The marked effective rate of ulinastatin group was higher than that of control group （65.3 % vs 50% ,P 〈 0.05 ）. There were significant differences in T, HR, RR, SpO2 , WBC, PCT, hs-CRP and oxygenation index between the two groups （P 〈 0. 05 ） after treatment at 3 days. The side effects were not reported. Conclusion Ulinastatin has good effect on elderly patients with aspiration pneumonia, which can reduce their lung injury and improve their prognosis, it is valuable in clinical treatment of aspiration pneumoma.