甲泼尼龙联合乌司他丁治疗重症帕金森病合并重症肺炎患者的疗效观察

Efficacy of methylprednisolone combined with ulinastatin in the treatment of severe Parkinson′s disease with severe pneumonia

目的研究甲泼尼龙联合乌司他丁治疗重症帕金森病合并重症肺炎患者的疗效。方法选择2016年1月至2019年1月西北工业大学医院收治的81例重症帕金森病合并重症肺炎患者,随机分为对照组(41例)和观察组(40例),均采用常规的帕金森病治疗。对照组给予甲泼尼龙,观察组在对照组的基础上联合静脉滴注乌司他丁。比较两组患者的治疗效果、炎症因子及呼吸功能相关指标水平。结果观察组的有效率明显高于对照组,差异有统计学意义(P<0.05)。治疗后,两组的血清白细胞介素(IL)-1β、肿瘤坏死因子(TNF)-α、IL-8、降钙素原(PCT)、C-反应蛋白(CRP)水平明显降低,差异有统计学意义(P<0.05),观察组上述指标水平明显低于对照组,差异有统计学意义(P<0.05)。治疗后,两组的呼吸频率和肺泡-动脉氧分压[P(A-a)O 2]明显降低,氧分压[Pa(O 2)]、肺适应性和氧合指数[Pa(O 2)/FiO 2]明显升高,差异均有统计学意义(P<0.05);且观察组的呼吸频率和P(A-a)O 2明显低于对照组,肺适应性和Pa(O 2)/FiO 2明显高于对照组,差异均有统计学意义(P<0.05)。结论甲泼尼龙联合乌司他丁能有效抑制重症帕金森病合并重症肺炎患者的炎性应激反应,改善呼吸功能,提高疗效。

Objective To study the effect of methylprednisolone combined with ulinastatin in the treatment of severe Parkinson′s disease with severe pneumonia.Methods A total of 81 cases of severe Parkinson′s disease and severe pneumonia who were treated in Hospital of Northwestern Polytechnical University from January 2016 to January 2019,were divided into two groups randomly.All patients were treated with conventional therapy of Parkinson′s disease.The control group was given methylprednisolone,and the observation group was given ulinastatin on the basis of the control group.The therapeutic effect,inflammatory factors and respiratory function were compared between the two groups.Results The effective rate in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the serum levels of interleukin(IL)-1β,tumor necrosis factor-α(TNF-α),IL-8,procalcitonin(PCT)and C-reactive protein(CRP)in the two groups decreased,and the difference was statistically significant(P<0.05).The levels of above indicators in the observation group were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).After treatment,the respiratory frequency and P(A-a)O 2 of the two groups were significantly decreased,Pa(O 2),lung adaptability and Pa(O 2)/FiO 2 were increased,and the differences were statistically significant(P<0.05).The respiratory frequency and P(A-a)O 2 in the observation group were significantly lower than those in the control group,lung adaptability and Pa(O 2)/FiO 2 were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Methylprednisolone combined with ulinastatin can effectively inhibit the inflammatory stress response of patients with severe Parkinson′s disease and severe pneumonia,improve their respiratory function and improve the therapeutic efficacy.