乌司他丁联合机械通气用于急性呼吸窘迫综合征的临床观察

目的探讨乌司他丁联合机械通气对急性呼吸窘迫综合征(ARDS)的临床疗效。方法将68例ARDS患者随机分为对照组(36例)和乌司他丁组(UTI组)(32例),对照组采用ARDS常规治疗,UTI组患者在此基础上确诊后即刻予乌司他丁(ulinastatin,UTI)注射液每日20万U静脉注射。观察两组患者治疗后疗效、血气分析指标及血清中TNF-α、IL-8含量。结果治疗后3 d、7 d UTI组患者动脉血氧分压(Pa O2)、氧合指数(Pa O2/Fi O2)改善优于对照组,组间差异有统计学意义(P<0.05),UTI组血清中TNF-α、IL-8及病死率均较对照组降低,差异有统计学意义(P<0.05)。结论 UTI联合机械通气治疗能够有效阻抑ARDS患者的炎性反应,改善患者氧合情况和预后。

Clinical Observation on Ulinastatin in Combination with Mechanical Ventilation in the Treatment of Acute Respiratory Distress Syndrome

Objective To investigate the effects of Ulinastatin in combination with mechanical ventilation in the treatment of acute respiratory distress syndrome（ARDS）.Methods Sixty-eight patients with ARDS were randomly divided into the control group（36 cases） and the ulinastatin group（group UTI）（32 cases）.The patients in the control group were treated with conventional therapy, Ulinastatin（20,000 U per day） by intravenous injection plus conventional therapy were used immediately after the diagnosis of ARDS was confirmed in the group UTI. Observed the effect of these treatment, the index of blood gas analysis, the serum concentrations of tumor necrosis factor-α（TNF-α）, interleukin-8（IL-8）.Result On the third day and the seventh day after treatment,the improvement of arterial partial pressure of oxygen（Pa O2）and oxygenation index were significantly better in group UTI than those in control group（P〈0.05）,there were significant statistical difference between group UTI and control group. The serum concentrations of TNF-α, IL-8 and the mortality rate of the group UTI were lower than those in the control group,（P〈0.01）there were significant statistical differernce. Conclusion The treatment of Ulinastatin in combination with mechanical ventilation can effectively inhibit the inflammatory reaction of patients with ARDS, and improve the oxygenation and prognosis of patients with ARDS.