乌司他丁联合甲基强的松龙治疗煤矿工人肺爆震伤早期血清C反应蛋白变化分析

Observation of early CPR changes of lung injury in coal mine workers treated with ulinastatin combined with methylprednisolone

目的观察乌司他丁联合甲基强的松龙治疗煤矿工人肺爆震伤时患者早期血清C反应蛋白（CRP）水平及治疗7天后对氧合指数（PO2/FiO2）的影响。方法回顾性选择60例煤矿工人肺爆震伤患者，随机分为乌司他丁治疗组（A组：对照组）和乌司他丁联合强的松龙治疗组（B组：联合治疗组），每组30例，检测两组患者不同时间血清CRP浓度及治疗7dPO2／FiO2值。结果给药前CRP（mg／L）A组：（121．44±4．69），B组：（118．29±4．57）。给药后48hCRP（mg／L）A组：（67．595±6．01），B组：（52．670±4．35）。治疗前PO2/FiO2A组：（179．72±30．61），B组：（176．65±28．48），治疗7d后对PO2/FiO2A组：（268．74±40．19），B组：（321．49±29．17）。两组患者C反应蛋白指标在治疗后48h较治疗前均有所改善，差异有统计学意义（P〈0．05），联合治疗组比对照组CRP降低更为显著，差异有统计学意义（P〈0．05）；治疗7d后，PO2/FiO2B组改善较A组明显，差异有统计学意义（P〈0．05）。结论乌司他丁联合强的松龙可以更好地改善煤矿工人肺爆震伤早期血清C反应蛋白状况，减轻炎症反应，治疗7d后，PO2/FiO2改善联合治疗组优于单纯乌司他丁组。

Objective To observe early serum C reactive protein （CRP） levels of lung blast injury in coal mine workers treated with ulinastatin combined with methylprednisolone, and their oxygen synthetic index （PO2/FiO2） 7 days after the treatment. Methods A retrospective analysis was conducted on two groups, group A, the control group which was only given Ulinastatin, and group B, the combined treatment group, with 30 cases of each group. The serum CRP concentration and PO2/FiO2 value between the two groups were compared. Results CRP levels of both groups improved （P 〈0.05）; the level of group B decreased even more significantly than group A （P 〈0.05）; 7 days after the treatment, PO2/FiO2 improvement was seen more obviously in group B than group （P 〈0.05）. Conclusion Ulinastatin combined with methylprednisolone is considered being effective in improving coal workers＂ lung blast injury early serum CRP, reducing inflammation, as well as a significant improvement of PO2/FiO2.