乌司他丁联合低分子肝素治疗老年急性呼吸窘迫综合征的疗效及对炎症反应与氧化应激的影响

Clinical efficacy of ulinastatin combined with low molecular heparin on acute respiratory distress syndrome and its influence on inflammatory reactions and oxidative stress

目的探讨乌司他丁联合低分子肝素治疗急性呼吸窘迫综合征(ARDS)的疗效及其对病人血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-1β、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平的影响。方法选取我院2014年7月至2017年6月收治的80例ARDS病人,随机分为观察组和对照组,每组40例。所有病人均采取相同的基础治疗,观察组在此基础上给予乌司他丁联合低分子肝素治疗。比较2组治疗前后血清TNF-α、IL-1β、SOD、GSH-Px水平变化及治疗效果。结果治疗7 d后,2组血清TNF-α、IL-1β水平均显著降低;血清SOD、GSH-Px水平均显著升高;氧和指数均显著上升;急性生理与慢性健康评分Ⅱ(APACHEⅡ)均显著下降,且观察组上述指标均改善更显著(均P<0.01)。与对照组相比,观察组机械通气时间、住ICU时间均显著缩短(P<0.01)。结论乌司他丁联合低分子肝素可减轻ARDS病人体内的炎症反应及氧化应激损伤,疗效确切。

Objective To investigate the clinical efficacy of ulinastatin combined with low molecular heparin（LMH） on acute respiratory distress syndrome（ARDS） and its influence on the serum levels of tumor necrosis factor（TNF）-α,interleukin（IL）-1β,superoxide dismutase（SOD）,glutathione peroxidase（GSH-Px） in patients with ARDS.Methods Eighty cases of patients with ARDS in our hospital from July 2014 to June 2017 were selected.They were divided into two groups randomly,with 40 cases in each group.All the patients were treated with same basic treatment,and the observation group was given ulinastatin combined with LMH additionally.The levels of TNF-α,IL-1β,SOD,GSH-Px in two groups were measured before and after treatment,and the clinical efficacy were compared between the two groups.Results After 7 days of treatment,the serum levels of TNF-α and IL-1β were decreased sighificantly,and the serum levels of SOD and GSH-Px and the oxygenation were increased remarkably,the scores of acute physiology and chronic health evaluationⅡ（APACHEⅡ） were significantly decreased in both groups,especially in the observation group（all P〈0.01）.The time of mechanical ventilation and ICU stay in observation group were significantly shorter than those in control group（P0.01）.Conclusions The combination of ulinastatin and LMH in treating ARDS proves to be effective,which can reduce inflammatory reactions and oxidative stress in the patients with ARDS.