乌司他丁对慢性阻塞性肺疾病患者炎症因子及临床疗效的影响

目的:探讨乌司他丁对慢性阻塞性肺疾病(COPD)急性加重期有创机械通气患者的肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)的调节作用及治疗效果的影响。方法:选取2012年1月至2013年12月某院重症医学科收治的COPD急性加重期有创机械通气患者120例,按随机数字表法随机分为治疗组与对照组(各60例),对照组给予常规治疗,治疗组在常规治疗基础上加用乌司他丁。采用酶联免疫吸附试验(ELISA)法测定两组患者血浆中的TNF-α、IL-6浓度,观察两组患者血清中炎性因子的浓度变化、住院时间、机械通气治疗时间、并发症发生例数及治疗费用。结果:所有患者治疗后均脱呼吸机好转出院。两组患者经治疗后血清TNF-α、IL-6浓度均明显降低,但治疗组降低更明显,两组差异有统计学意义(P<0.05);治疗组患者住院时间、机械通气治疗时间、并发症发生例数及治疗费用均低于对照组患者(P<0.05)。结论:乌司他丁能减轻COPD有创机械通气患者的机体炎症反应,缩短治疗时间,改善短期预后,有较好的临床疗效及经济效应。

Effect of Ulinastatin on the Inflammatory Factors and Clinical Efficacy in Patients with Chronic Obstruc- tive Pulmonary Disease

OBJECTIVE：To investigate the regulatory effects of ulinastatin on tumor necrosis factor-α（TNF-α）and interleukin 6（IL-6）and its clinical efficacy in patients with acute exacerbation of chronic obstructive pulmonary disease（COPD）undergoing invasive mechanical ventilation. METHODS：A total of 64 patients with acute exacerbation of COPD admitted to our hospital from Jan. 2012 to Dec. 2013 were randomly assigned to receive either routine therapy alone（control group）or routine therapy plus Ulina-statin （trial group） of 60 each. Plasma levels of TNF-α and IL-6 were determined by ELISA and the inflammatory factors in both groups,length of hospital stay,mechanical ventilation time,the number of complications and treatment costs were recorded. RE-SULTS：All patients weaned successfully from the mechanical ventilator and discharged from hospital with recovery after treatment. Serum levels of TNF-α and IL-6 in both groups declined significantly after treatment,much as in the treatment group,showing sta-tistically significant differences between two groups （P〈0.05）;the length of hospital stay,the mechanical ventilation time,the number of complications and the treatment costs were all lower in the trial group than in the control group （P〈0.05）. CONCLU-SIONS：Ulinastatin can relieve ventilation it is of good clinical efficacy and economic efficacy inflammatory response,shorten treat-ment time,improve short-term outcome in patients with COPD receiving invasive mechanical ventilation. It is of good clinical and economic efficacy.