血液净化联合乌司他丁对脓毒症急性肺损伤患者血清VEGF-内皮素受体及CRP-Hcy水平的影响

Effects of blood purification combined with ulinastatin on the serum levels of vascular endothelin receoptor and CRP-Hcy in patients with sepsis-induced acute lung injury

目的分析血液净化联合乌司他丁对脓毒症急性肺损伤患者血清血管内皮生长因子(VEGF)-内皮素受体及C-反应蛋白-同型半胱氨酸(CRP-Hcy)水平的影响。方法选择2019年12月至2021年12月诊治的脓毒症急性肺损伤患者180例,按治疗方法分为对照组(n=80,常规治疗的基础上接受持续性血压净化)和观察组(n=100,常规治疗的基础上接受持续性血液净化联合乌司他丁治疗)。分析2组患者治疗后肺功能改善情况,免疫印迹法分析VEGF及内皮素受体水平的变化,全自动生化分析仪分析CRP-Hcy水平的变化。结果脓毒症急性肺损伤患者治疗后肺功能参数最大通气量、肺活量及氧合指数均显著升高(P<0.05)、APACHEⅡ评分均显著降低(P<0.05),随着治疗时间的延长,上述指标变化越明显(P<0.05),且观察组患者的上述指标较对照组变化更显著(P<0.05);脓毒症急性肺损伤患者治疗后血清中VEGF、VEGFR、内皮素受体、CRP、Hcy及IL-1β水平均明显降低(P<0.05),与对照组比较,观察组患者的上述指标降低更明显(P<0.05)。结论血液净化联合乌司他丁能有效改善脓毒症急性肺损伤患者肺功能、降低血清VEGF-内皮素受体及CRP-Hcy-IL-1β水平。

Objective To investigate the effects of blood purification combined with ulinastatin on the serum levels of vascular endothelin receoptor and CRP-Hcy in patients with sepsis-induced acute lung injury,so as to provided reference for clinical treatment.Methods A total of 180 patients with sepsis acute lung injury who were treated in our hospital from December 2019 to December 2021 were enrolled in the study,who were were divided into control group(n=80)and observation group(n=100)according to different treatment methods.The patients in control group,on the basis of conventional therapy,were treated by continuous blood pressure purification,however,the patients in observation group,on the basis of conventional therapy,were treated by continuous blood purification combined with ulinastatin.After treatment the improvement status of pulmonary function,and the levels of VEGF and vascular endothelin receoptor detected by Western Blot,and the levels of CRP-Hcy detected by automatic biochemical analyzer were observed and compared between the two groups.Results After treatment,the maximal ventilation volume,vital capacity and oxygenation index of pulmonary function parameters in both groups were significantly increased(P<0.05),however,the APACHEⅡscores were significantly decreased(P<0.05),moreover,the changes of the above indexes in observation group were more significant than those in control group(P<0.05).After treatment the serum levels of VEGF,endothelin receoptor,CRP,Hcy and IL-1beta in both groups were significantly decreased(P<0.05),moreover,the decrease degree in observation group was more significant than that in control group(P<0.05).Conclusion The blood purification combined with ulinastatin can effectively improve the pulmonary function and decrease the serum levels of vascular endothelin and CRP-Hcy-IL-1beta in patients with sepsis-induced acute lung injury.