乌司他丁联合胸腺肽对重症肺炎患者呼吸功能和炎症应激反应的影响

Effect of ulinastatin combined with thymosin on respiratory function and inflammatory stress response in patients with severe pneumonia

目的探究乌司他丁联合胸腺肽对重症肺炎患者呼吸功能和炎症应激反应的影响。方法选取2015年9月至2017年4月海南省人民医院收治的重症肺炎患者63例作为研究对象,按照随机数字表法将其分为对照组(31例)和观察组(32例)。对照组采取一般临床治疗,观察组在对照组的基础上给予乌司他丁和胸腺肽治疗,对比分析2组患者治疗前后的血气指标、炎症指标、炎性细胞因子、应激反应指标水平及急性生理学和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分。结果治疗后观察组患者动脉血二氧化碳分压、降钙素原、C反应蛋白、D-二聚体、肿瘤坏死因子α、白细胞介素6、丙二醛水平及APACHEⅡ评分明显低于对照组[(60±7)mm Hg(1 mm Hg=0. 133 k Pa)比(66±7)mm Hg、(5. 5±2. 1)μg/L比(7. 4±2. 7)μg/L、(5. 3±2. 0)mg/L比(7. 6±2. 5)mg/L、(2. 7±1. 2)mg/L比(4. 9±1. 7)mg/L、(34±10)ng/L比(43±11)ng/L、(25±9)ng/L比(38±10)ng/L、(6. 4±1. 2)μmol/L比(7. 5±1. 4)μmol/L、(14±4)分比(17±6)分];动脉血氧分压、动脉血氧饱和度、白细胞介素10和超氧化物歧化酶水平明显高于对照组[(92±12)mm Hg比(83±11)mm Hg、(96±11)%比(89±10)%、(26±5)ng/L比(18±4)ng/L、(88±18) U/L比(71±17) U/L],差异均有统计学意义(均P <0. 05)。结论乌司他丁联合胸腺肽对重症肺炎患者呼吸功能、炎症应激反应的影响明显,可显著改善患者血气指标,降低患者血清炎症指标水平,减少应激反应。

Objective To explore the effect of ulinastatin combined with thymosin on respiratory function,inflammatory and stress response in patients with severe pneumonia. Methods Sixty-three patients with severe pneumonia admitted to Hainan General Hospital from September 2015 to April 2017 were randomly divided into control group(31 cases) and observation group(32 cases). The control group was treated with routine therapy;the observation group was treated with ulinastatin and thymosin on the basis of routine therapy. Blood gas indexes,inflammatory markers,inflammatory cytokines,stress response indexes and score of Acute Physiology and Chronic Health Evaluation Ⅱ( APACHE Ⅱ) were analyzed. Results After treatment,arterial partial pressure of carbon dioxide,levels of procalcitonin,C-reactive protein,D-dimer,tumor necrosis factor-α,interleukin-6,malondialdehyde and APACHE Ⅱ score were significantly lower in the observation group than those in the control group [( 60 ±7) mm Hg vs(66 ± 7) mm Hg,(5. 5 ± 2. 1)μg/L vs(7. 4 ± 2. 7)μg/L,(5. 3 ± 2. 0) mg/L vs(7. 6 ± 2. 5) mg/L,(2. 7 ± 1. 2)mg/L vs(4. 9 ± 1. 7)mg/L,(34 ± 10)ng/L vs(43 ± 11)ng/L,(25 ± 9)ng/L vs(38 ± 10)ng/L,(6. 4 ± 1. 2)μmol/L vs(7. 5 ± 1. 4)μmol/L,(14 ± 4)vs(17 ± 6)];arterial partial pressure of oxygen,arterial oxygen saturation,interleukin-10 and superoxide dismutase levels in the observation group were significantly higher than those in the control group [(92 ± 12) mm Hg vs(83 ± 11) mm Hg,( 96 ± 11)% vs( 89 ± 10)%,( 26 ±5) ng/L vs(18 ± 4) ng/L,(88 ± 18) U/L vs(71 ± 17) U/L]( all P < 0. 05). Conclusion Ulinastatin combined with thymosin can obviously improve respiratory function and blood gas,reduce inflammation and stress response in patients with severe pneumonia.