乌司他丁联合多巴酚丁胺治疗重症肺炎合并心力衰竭的临床研究及对患者炎性因子的影响

Clinical Study of Ulinastatin Combined with Dobutamine in the Treatment of Severe Pneumonia Complicated with Heart Failure and its Influence on Inflammatory Factors

目的分析在重症肺炎合并心力衰竭疾病患者的治疗过程中选择乌司他丁、多巴酚丁胺联合治疗的临床效果及药物对患者炎性因子的具体影响。方法选取2018年8月至2019年8月在河南省驻马店市中心医院接受治疗的84例重症肺炎合并心力衰竭患者,运用单双数字分组方式将纳入对象均分为对照组和观察组,各42例。对照组患者进行常规对症治疗+多巴酚丁胺治疗,观察组患者在此基础上增加乌司他丁治疗。通过数据分析,对比两组在运用不同治疗方式后的临床疗效、各项临床症状缓解时间、治疗前后的炎性因子水平、肺功能情况、用力肺活量(FVC)、心功能情况以及在治疗过程中出现的不良反应。结果通过分析对比治疗结束后的各项数据得知,观察组治疗有效率显著高于对照组,差异有统计学意义(P<0.05)。临床治疗状态显示,观察组心率、呼吸恢复正常时间以及湿啰音消失时间明显更短,差异有统计学意义(P<0.05)。治疗前,两组患者体内炎性因子水平差异较小,差异无统计学意义(P>0.05),但通过用药治疗后,观察组IFN-γ、IL-10、FEV1、FVC、EF等指标水平更高,TNF-α、ESV等指标水平更低,差异有统计学意义(P<0.05)。对药物以及机体不良反应进行对比发现,观察组患者出现不良反应的概率与对照组,差异无统计学意义(P>0.05)。结论对重症肺炎合并心衰患者给予乌司他丁、多巴酚丁胺联合治疗,既可显著提升疾病有效率、减轻炎症程度,又可帮助其改善心肺功能、减少不良反应,值得应用。

Objective To analyze the clinical effect of uinastatin combined with dobutamine and the specific effect of drugs on inflammatory factors in the treatment of severe pneumonia combined with heart failure.Methods A total of 84 patients with severe pneumonia combined with heart failure treated in Zhumadian Central Hospital of Henan Province from August 2018 to August 2019 were divided into control group and observation group by single-even digital grouping mode,with 42 patients in each group.The control group of patients received routine symptomatic treatment plus dobutamine treatment,and the patients in the observation group had added ulinastatin treatment on this basis.Through the data analysis,the clinical efficacy,the remission time of various clinical symptoms,the level of inflammatory factors,pulmonary function,forced lung capacity(FVC),cardiac function before and after the treatment,and the adverse reactions during the treatment process were compared between two groups.Results By analyzing and comparing the data after the treatment,the total treatment response rate in the observation group was significantly higher than the control group,the difference was statistically significant(P<0.05);The clinical treatment status showed,heart rate,breathing returned to normal time and wet rale disappear time in the observation group were significantly shorter than those in the control group,with statistically significant differences(P<0.05);Before treatment,there had no differences in inflammatory factors levels between the two groups(P>0.05),But after taking the drug for treatment,The observation group had higher index levels of IFN-γ,IL-10,FEV1,FVC,EF indicators,and had lower levels of TNF-α,ESV indicators,with statistically significant differences(P<0.05);Comparison of drugs and adverse reactions to the body,the probability of adverse effects in the observation group was not significantly different from the control group(P>0.05).Conclusion The combination treatment of ulinastatin and dobutamine for patients with severe pneumonia combined with heart failure can not only significantly improve the disease efficiency and reduce the inflammation degree,but also help them to improve their cardiopulmonary function and reduce adverse reactions,which is worth application.