乌司他丁联合CRRT治疗对急性呼吸窘迫综合征患者内皮氧化性损伤和炎症性损伤的影响

Effect of ulinastatin combined with CRRT therapy on the endothelial oxidative damage and inflammatory injury in patients with acute respiratory distress syndrome

目的:探讨乌司他丁联合CRRT治疗对急性呼吸窘迫综合征(ARDS)患者内皮氧化性损伤和炎症性损伤的影响。方法:收集本院收治的ARDS患者60例,回顾治疗方案及相关实验室检查,分为接受单纯CRRT治疗的对照组29例,接受乌司他丁联合CRRT治疗的联合治疗组31例。治疗前、治疗5d后,采用酶联免疫吸附法(ELISA)检测血清、呼出气冷凝液中内皮功能指标、炎症反应指标含量;采用放射免疫法检测血清、呼出气冷凝液中氧化应激指标含量。结果:治疗前,两组血清、呼出气冷凝液中内皮功能、氧化应激、炎症反应指标的差异无统计学意义(P>0.05)。治疗后,观察组血清及呼出气冷凝液中内皮功能指标NO含量高于对照组,ET-1含量低于对照组;氧化应激指标CAT、SOD含量高于对照组,MAO含量低于对照组;炎症反应指标PCT、IL-1β、HMGB1含量低于对照组。结论:乌司他丁联合CRRT治疗能够改善ARDS患者的内皮功能,减轻氧化应激及炎症损伤。

Objective： To study the effect of ulinastatin combined with CRRT therapy on the endothelial oxidative damage and inflammatory injury in patients with acute respiratory distress syndrome （ARDS）. Methods： A total of 60 patients with ARDS who were treated in our hospital between April 2011 and April 20t6 were collected and divided into the control group （n =29） who received pure CRRT therapy and the combined treatment group （n =31） who received ulinastatin combined with CRRT therapy after the therapy and related laboratory examination were reviewed. Before treatment and after 5 d of treatment, enzyme-linked immunosorbent assay （ELISA） was used to detect the levels of endothelial function indexes and inflammation indexes in serum and exhaled breath condensate; RIA method was used to detect the levels of oxidative stress indexes in serum and exhaled breath condensate. Results： Before treatment, the differences in the endothelial function, oxidative stress and inflammation indexes in serum and exhaled breath condensate were not statistically significant between two groups of patients （P 〉0.05）. After treatment, endothelial function index NO levels in serum and exhaled breath condensate of observation group were higher than those of control group while ET-1 levels were lower than those of control group （P〈0.05） ; oxidative stress indexes CAT and SOD levels in serum and exhaled breath condensate of observation group were higher than those of control group while MAO levels were lower than those of control group （P 〈0.05）; inflammation indexes PCT, IL-1β and HMGB1 levels in serum and exhaled breath condensate of observation group were lower than those of control group （P〈0.05）. Conolusions.. Ulinastatin combined with CRRT therapy can improve the endothelial function and reduce the oxidative stress and inflammatory injury in patients with ARDS.