亚胺培南-西司他丁钠联合低分子量肝素钠治疗脓毒症所致急性呼吸窘迫综合征的效果

Effect of Imipenem and Cilastatin Sodium Combined with Low Molecular Weight Heparin Sodium in the Treatment of Acute Respiratory Distress Syndrome Caused by Sepsis

目的:探究亚胺培南-西司他丁钠联合低分子量肝素钠治疗脓毒症所致急性呼吸窘迫综合征(ARDS)的效果。方法:选取2019年5月—2022年4月涟水县人民医院收治的96例脓毒症所致ARDS患者。根据随机电脑数字法将其均分为对照组及研究组,各48例。两组均给予综合治疗,对照组给予注射用亚胺培南-西司他丁钠,研究组给予注射用亚胺培南-西司他丁钠联合注射用低分子量肝素钠。比较两组治疗前后炎症指标、氧化应激指标、病情稳定情况及不良反应。结果:治疗后,两组白细胞计数(WBC)、超敏C反应蛋白(hs-CRP)水平降低,白细胞介素-10(IL-10)水平升高,研究组WBC、hs-CRP水平均低于对照组,IL-10水平高于对照组,差异有统计学意义(P<0.05)。治疗后,两组谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)水平均升高,研究组GSH-Px、SOD水平均明显高于对照组,差异有统计学意义(P<0.05)。治疗后,两组Murray肺损伤、序贯器官衰竭评分(SOFA)评分下降,研究组Murray肺损伤、SOFA评分均明显低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:对脓毒症所致ARDS患者予以亚胺培南-西司他丁钠联合低分子量肝素钠治疗能显著提升效果,改善其炎症、氧化应激反应,有效控制病情发展,同时不增加用药不良反应,安全可靠。

Objective:To investigate the effect of Imipenem and Cilastatin Sodium combined with Low Molecular Weight Heparin Sodium in the treatment of acute respiratory distress syndrome(ARDS)caused by sepsis.Method:A total of 96 patients with ARDS caused by sepsis admitted to Lianshui County People's Hospital from May 2019 to April 2022 were selected.According to the random computer numerical method,they were evenly divided into a control group and a study group,with 48 cases in each group.Both groups was given comprehensive treatment,the control group was given Imipenem and Cilastatin Sodium for Injection,and the study group was given Imipenem and Cilastatin Sodium for Injection combined with Low Molecular Weight Heparin Sodium for Injection.Inflammatory indexes,oxidative stress indexes,disease stable condition before and after treatment and adverse reactions were compared between the two groups.Result:After treatment,the levels of white blood cell count(WBC)and hypersensitive C-reactive protein(hs-CRP)decreased,while the levels of interleukin-10(IL-10)increased in both groups,the levels of WBC and hs-CRP in the study group were lower than those in the control group,while the levels of IL-10 was higher than that in the control group,the differences were statistically significant(P<0.05).After treatment,the levels of glutathione peroxidase(GSH-Px)and superoxide dismutase(SOD)in both groups were increased,and the levels of GSH-Px and SOD in the study group were significantly higher than those in the control group,the differences were statistically significant(P<0.05).After treatment,Murray lung injury and sequential organ failure assessment(SOFA)scores in both groups decreased,and Murray lung injury and SOFA score in study group were significantly lower than those in control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Imipenem and Cilastatin Sodium for Injection combined with Low Molecular Weight Heparin Sodium for Injection treatment can significantly improve the efficacy of patients with ARDS caused by sepsis,improve inflammation and oxidative stress reactions,effectively control the development of the disease,and do not increase adverse drug reactions,safe and reliable.