乌司他丁对脓毒症急性肺损伤的保护作用研究

Protective effects of ulinastatin on sepsis induced acute lung injury

目的:观察乌司他丁对脓毒症急性肺损伤的保护作用,并探讨其可能的作用机制。方法:收集2017-04—2018-05期间接受治疗的脓毒症伴发急性肺损伤患者124例,按照患者入院顺序随机分为观察组和对照组,每组62例。对照组常规治疗,观察组在常规治疗基础上加用乌司他丁20万单位/d,静脉滴注。ELISA法检测p65、TNF-α、IL-6表达。结果:治疗前,两组p65、TNF-α和IL-6水平比较,差异无统计学意义(P>0.05)。治疗后,观察组p65、TNF-α和IL-6水平分别为(24.36±4.33)μg/L、(31.38±6.06)μg/L和(18.52±3.38)μg/L,显著低于对照组的(38.24±7.25)μg/L、(46.36±7.54)μg/L和(32.16±5.23)μg/L(P<0.01)。治疗前,两组PaO_2和PaO_2/FiO_2比较,差异无统计学意义(P>0.05)。治疗后,观察组PaO_2和PaO_2/FiO_2分别为(80.23±12.63)mmHg、(387.82±62.33)mmHg,均显著高于对照组的(67.28±10.26)mmHg和(322.18±54.27)mm-Hg,差异有统计学意义(P<0.05)。观察组有效率为90.3%(56/62),显著高于对照组的75.8%(47/62)。结论:乌司他丁可以抑制脓毒症急性肺损伤患者炎症反应,改善患者肺功能,临床疗效显著。

Objective:To observe the protective effects of ulinastatin on sepsis induced acute lung injury.Method:124 sepsis induced acute lung injury patients were divided into control group(n=62)and observation group(n=62).The control group was given conventional treatment,and the observation group on the base of control group was given ulinastatin.p65,TNF-α,IL-6 were detected by ELISA analysis.Result:There was no significant difference in the levels of p65,TNF-and IL-6 between the two groups before treatment(P>0.05).After treatment,the p65,TNF-α,IL-6 in observation group was 24.36±4.33μg/L,31.38±6.06μg/L,and 18.52±3.38μg/L,which were significantly lower than those in control group(38.24±7.25,46.36±7.54 and 32.16±5.23μg/L,P <0.01).There was no significant difference of PaO2 and PaO2/FiO2 between the two groups before treatment(P>0.05).After treatment,the PaO2 and PaO2/FiO2 in observation group were(80.23±12.63)mmHg and(387.82±62.33)mmHg,which were significantly higher than those in control group(67.28±10.26 and 322.18±54.27 mmHg),P<0.05).The effective rate of observation group was 90.3%(56/62),which was significantly higher than that in control group(75.8%)(47/62)(P<0.05).Conclusion:Ulinastatin can inhibit the inflammation reaction in septic patients with acute lung injury to improve lung function.