Neutrophil elastase(NE),a major protease in the primary granules of neutrophils,is involved in microbicidal activity.NE is an important factor promoting inflammation,has bactericidal effects,and shortens the inflammat...Neutrophil elastase(NE),a major protease in the primary granules of neutrophils,is involved in microbicidal activity.NE is an important factor promoting inflammation,has bactericidal effects,and shortens the inflammatory process.NE also regulates tumor growth by promoting metastasis and tumor microenvironment remodeling.However,NE plays a role in killing tumors under certain conditions and promotes other diseases such as pulmonary ventilation dysfunction.Additionally,it plays a complex role in various physiological processes and mediates several diseases.Sivelestat,a specific NE inhibitor,has strong potential for clinical application,particularly in the treatment of coronavirus disease 2019(COVID-19).This review discusses the pathophysiological processes associated with NE and the potential clinical applications of sivelestat.展开更多
文摘目的:观察西维来司他钠治疗脓毒症伴急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)的效果。方法:将阳江市人民医院2023年6—12月收治的脓毒症伴ARDS患者总计60例,以随机数字表法分成两组,各30例,其中一组以常规治疗为对照组,另一组以常规治疗配合西维来司他钠治疗为研究组,均治疗7 d。比较两组血清学指标(炎症指标、血小板计数、血气指标),急性生理和慢性健康状况Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)评分、肺损伤评分,序贯器官衰竭估计(sequential organ failure assessment,SOFA)评分,机械通气时间及病死率。结果:治疗前,两组炎症指标、血气指标、血小板计数、APACHEⅡ评分、肺损伤评分、SOFA评分相比,差异均无统计学意义(P>0.05);治疗后,两组血清炎症指标、动脉血二氧化碳分压、APACHEⅡ评分、肺损伤评分、SOFA评分均较治疗前显著下降,且研究组均低于对照组,动脉血氧饱和度及血小板计数均较治疗前提升,研究组均高于对照组,差异均有统计学意义(P<0.05)。研究组机械通气时间短于对照组,差异有统计学意义(P<0.05)。两组的14 d病死率相比,差异无统计学意义(P>0.05)。结论:脓毒症伴急性呼吸窘迫综合征患者在接受西维来司他钠治疗,可显著减轻患者的血清炎症指标水平,改善血气指标,减轻肺损伤,缩短患者的机械通气时间,效果理想。
基金This work has been supported by the Liaoning Province Natural Science Foundation(Grant Nos.:2020-ZLLH-47,2020-MS-065,2021-YGJC-02,and 2017225054).Figures in the paper were drawn using Figdraw,and we sincerely thank the free drawing support provided by the Figdraw platform(www.fgdraw.com).We also would like to thank Editage(www.editage.cn)for English language editing.
文摘Neutrophil elastase(NE),a major protease in the primary granules of neutrophils,is involved in microbicidal activity.NE is an important factor promoting inflammation,has bactericidal effects,and shortens the inflammatory process.NE also regulates tumor growth by promoting metastasis and tumor microenvironment remodeling.However,NE plays a role in killing tumors under certain conditions and promotes other diseases such as pulmonary ventilation dysfunction.Additionally,it plays a complex role in various physiological processes and mediates several diseases.Sivelestat,a specific NE inhibitor,has strong potential for clinical application,particularly in the treatment of coronavirus disease 2019(COVID-19).This review discusses the pathophysiological processes associated with NE and the potential clinical applications of sivelestat.
