血必净联合乌司他丁治疗重症肺炎的临床研究

目的观察血必净联合乌司他丁治疗重症肺部感染临床疗效。方法 237例重症肺炎患者随机分为对照组、血必净组、乌司他丁组及血必净+乌司他丁联合治疗组,治疗前、治疗1周、2周分别测定纤维支气管镜肺灌洗液中蛋白含量/血浆蛋白、中性粒细胞数目(N)及炎症因子IL-6浓度,监测血气分析氧分压、肺泡-动脉氧分压差,测定肺顺应性变化,评估肺功能恢复情况。结果 4组患者治疗2周后纤维支气管镜肺灌洗液中IL-6水平、中性粒细胞数目、白蛋白含量/血浆白蛋白均明显下降,肺顺应性提高,血气分析氧分压提高,肺泡-动脉氧分压差下降,肺功能改善,但均以联合治疗组效果最好,组间比较有显著差异(P均<0.05)。结论血必净联合乌司他丁可有效治疗重症肺部感染,原因与强效抗感染、改善机体氧和、降低毛细血管通透性等有关。

Clinical study on Xuebijing injection and ulinastatin in treatment of patients with severe pneumonia

Objective To observe the clinical efficacy of Xuebijing injection and ulinastatin in treatment of severe pneumonia.Methods Two hundred and thirty seven cases of severe pneumonia were randomly allocated into control group,Xuebijing group,ulinastatin group,Xuebijing and ulinastatin combination group.The protein content/plasma proteins of bronchoalveolar lavage fluid（BALF）,number of neutrophils and inflammatory factor IL-6 concentration were detected,and PaO2 and P（A-a）O2 of blood gas analysis,pulmonary compliance changes by end-tidal airway occlusion technique were monitored before and 1 to 2 weeks after the experiment for evaluation of recovery of lung function.Results Compared with the control group,the others after 2 weeks of treatment,IL-6 of BALF 、 number of neutrophils and protein content、plasma proteins were significantly decreased.Pulmonary compliance、and PaO2、were increased,P（A-a）O2 was decreased,and pulmonary ventilation function had been improved.The efficacy of Xuebijing and ulinastatin combination group was the best.Conclusion The combination of Xuebijing injection and ulinastatin is more effective in treatment of patients with severe pneumonia,and the causes are relevant to potent anti-infection activity,improvement in body oxygen and reduction of capillary permeability.