早期大剂量乌司他丁联合沐舒坦治疗特重度烧伤对患者呼吸功能及炎性因子的影响

Effects of early high-dose ulinastatin combined mucosolvan on respiratory function and levels of inflammatory cytokines in patients with severe burns

目的探讨早期大剂量乌司他丁联合沐舒坦治疗特重度烧伤对患者呼吸功能及炎性因子水平的影响。方法收集特重度烧伤患者100例,随机分为观察组与对照组各50例,2组患者均给予常规烧伤方案治疗,同期观察组患者给予早期乌司他丁40万U联合450 mg大剂量沐舒坦治疗,对照组给予早期乌司他丁10万U联合沐舒坦30 mg常规剂量治疗,观察2组患者治疗后呼吸功能指标及炎性因子水平变化情况。结果 12组患者治疗后呼吸频率、PaO2、PaO2/Fi O2各时间点单因素重复测量方差分析有统计学意义(P<0.05);观察组治疗7、12 d后呼吸频率较对照组下降明显,治疗3、7、12 d后PaO2、PaO2/Fi O2较对照组升高明显,2组比较差异有统计学意义(P<0.05);22组患者治疗后血清TNF-α、IL-1、IL-6、IL-8水平各时间点单因素重复测量方差分析有统计学意义(P<0.05),治疗3、7 d血清TNF-α、IL-1、IL-6、IL-8水平增高,治疗12 d各指标水平下降;观察组治疗3、7 d血清TNF-α、IL-1、IL-6、IL-8水平增高低于对照组,12 d下降较对照组显著,2组比较差异均有统计学意义(P<0.05)。结论早期大剂量乌司他丁联合沐舒坦治疗特重度烧伤对保护呼吸功能、调低炎症因子水平临床效果显著。

Objective To explore the effects of early high-dose ulinastatin combined Mucosolvan on respiratory function and levels of inflammatory cytokines in patients with severe burns. Methods One hundred severe burn patients were ran- domly divided into observation group and control group. All the patients were given conventional regimen burns, at the same period, the observation group was treated with early high-dose ulinastatin 400 000 U combined Mucosolvan 450 mg, the control group was given regular doses of early Ulinastatin 100 000 U combined Mucosolvan 30 mg. The respiratory function parameters and inflammatory cytokines were observed. Results ①After the treatment, one-way repeated-meas- ures ANOVA showed that the respiratory rate, PaO2, PaO2/FiO2 at each time point was statistically significant （ P 〈 0.05 ） ; the respiratory rate of the observation group decreased significantly when compared with the control group 7 d and 12 d after the treatment, while PaO2 and PaO2/FiO： increased significantly as compared with the control group 3 d,7 d and 12 d after the treatment, the difference was statistically significant （P 〈 0.05 ） ;②After the treatment, one-way repeat- ed-measures ANOVA showed that serum TNF-α, IL-1, IL-6 and IL-8 levels at each time point statistically significant（ P 〈 0.05 ） ,serum TNF-α, IL-1, IL-6 and IL-8 levels increased at d2 and d7 ,but decreased at d12 after the treatment ;the in- creased serum TNF-a, IL-1, IL-6, IL-8 levels were not obviously as compared with the control group, while the levels at d12 declined significantly when compared with the control group, the difference was statistically significant（ P 〈 0. 05 ）. Conclusion Early high-dose nlinastatin combined Mucosolvan for the patients with severe burns can protect their respir- atory function, reduce the levels of inflammatory cytokines with a significant clinical effect.