乌司他丁对AECOPD的临床疗效及作用机制探讨

Clinical effect and mechanism of ulinastatin for AECOPD

目的探讨乌司他丁治疗慢阻肺急性加重期(AECOPD)患者的临床效果及其作用机制。方法选取本院2015年6月至12月收治的AECOPD患者140例,采用随机数字表法分为乌司他丁组和对照组,各70例。乌司他丁组男44例,女26例,年龄(66.3±9.7)岁。对照组男41例,女29例,龄(65.0±10.8)岁。两组均给予吸氧、抗炎、止咳平喘等基础治疗,乌司他丁组同时加用乌司他丁,疗程均为14 d。比较两组临床效果。结果治疗前,乌司他丁组和对照组PaO2、PaCO2、FEV1%、TNF-α、IL-6、HMGB1、TLR4、SOD测定值差异无统计学意义(均P>0.05);治疗后,乌司他丁组的PaO2、FEV1%、SOD测定值高于对照组(均P<0.05),PaCO2、TNF-α、IL-6、HMGB1、TLR4水平低于对照组(均P<0.05);治疗14 d后,乌司他丁组治疗总有效率95.71%(67/70),高于对照组的84.29%(59/70),差异具有统计学意义(P<0.05)。结论乌司他丁治疗AECOPD患者主要通过减轻机体炎症反应、氧化应激反应,从而改善患者的血气及肺功能,达到提高治疗效果的目的。

Objective To study the clinical effect and mechanism of ulinastatin for patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods 140 AECOPD patients treated in our hospital from June to December,2015 were randomly divided into an ulinastatin group and a control group,with 70 cases in each group.There were 44 male and 26 female in the ulinastatin group;they were(66.3±9.7)years old.There were 41 male and 29 female in the control group;they were(65.0±10.8)years old.Both groups were given oxygen,anti-inflammatory,and antitussive and antiasthmatic therapy;in addition,the ulinastatin group was treated with ulinastatin.Both groups were treated for 14 days.The clinical effects were compared between these two groups.Results Before the treatment,there were no statistical differences in PaO2,PaCO2,FEV1%,TNF-α,IL-6,HMGB1,TLR4,and SOD between these two groups(all P>0.05).After the treatment,the levels of PaO2,FEV1%and SOD were higher and the levels of PaCO2,TNF-α,IL-6,HMGB1,and TLR4 were lower in the ulinastatin group than in the control group(all P<0.05).After 14 days’treatment,the total effective rate was higher in the ulinastatin group than in the control group[95.71%(67/70)vs.84.29%(59/70)],with a statistical difference(P<0.05).Conclusion Ulinastatin in the treatment of AECOPD can improve the effect,because it reduces the patients’inflammatory reaction and oxidative stress,and improve their blood gas and lung function.