乌司他丁对急性呼吸窘迫综合征患者凝血功能的影响

目的探讨乌司他丁对急性呼吸窘迫综合征（ARDS）患者凝血功能的影响。方法将80例ARDS患者按随机数字表法分为治疗组和对照组，各40例。对照组给予机械通气、抗感染、营养支持治，治疗组在此基础上加用乌司他丁针10万U＋0.9%氯化钠溶液100ml静脉滴注3次/d，连续7d。比较两组患者住ICU时间、机械通气时间、28d病死率以及治疗前后急性生理学与慢性健康状况Ⅱ（APACHEⅡ）评分、氧合指数、血浆凝血酶原时间（PT）、纤维蛋白原（FIB）和D-二聚体（D- D）水平及血小板计数（Plt）变化。结果治疗组住 ICU时间、28d病死率、APACHE Ⅱ评分均低于对照组（均P＜0.05），氧合指数、FIB、Plt水平均高于对照组（均P＜0.05），PT、D- D水平治疗后低于对照组（均P＜0.05）。结论在常规治疗的基础上，应用乌司他丁治疗能改善ARDS患者的凝血功能及炎症指标，缩短机械通气时间、入住ICU时间，降低病死率。

Effects of ulinastatin on blood coagulation in patients with acute respiratory distress syndrome

Objective To investigate the effects of ulinastatin on blood coagulation in patients with acute respiratory dis-tress （ARDS）. Methods Eighty ARDS patients were randomly divided into treatment group（n=40） and control group（n=40）. Pa-tients in both groups received mechanical ventilation, anti- infection and nutritional support;patients in treatment group received ulinastatin injection 100,000U, q.8.h for 7d. The length of ICU stay, duration of mechanical ventilation, 28- d mortality, the A-PACHE II scores before and after treatment, oxygenation index （PaO2 / FiO2）, plasma prothrombin time （PT）, fibrinogen （Fib）, D- dimer （D- D） concentration and platelet count（Plt） were compared between two groups. Results In the treatment group, the length of ICU stay, the 28- d mortality rate, APACHEⅡsccores were lower than those of control group （P〈0.05）;the oxygena-tion index, Fib and Plt were higher than those of the control group（P〈0.05）;the PT and D- D concentrations after treatment were lower than those in control group （P〈0.05）. Conclusion Administration of ulinastatin on the basis of routine treatment can im-prove the function of blood coagulation and the inflammatory index, shorten the duration of mechanical ventilation, ICU stay time and reduce mortality in patients with acute respiratory distress syndrome.