摘要
目的 比较西维来司他钠联合乌司他丁对急性呼吸窘迫综合征(ARDS)患者的影响.方法 选取2021年5月至2023年5月诊治的202例ARDS患者进行研究,按抛硬币法将所有患者分为A组(n=101例,乌司他丁治疗)和B组(n=101例,西维来司他钠联合乌司他丁治疗).记录2组患者生命体征(血压、心率、体温、呼吸)、炎性反应[降钙素原(PCT)、内毒素脂多糖(LPS)、溶酶体酶(LE)]、血气指标[氧合指数(PaO2/FiO2)、血乳酸(Lac)、活性碳酸酐酶(CA)]、肺功能[肺动态顺应性(Cdyn)、预测性呼气末正压(PEEP)、气道阻力(Raw)]水平及不良反应变化.结果 治疗后,2组患者心率、体温、呼吸水平显著降低(P＜0.05),而血压水平显著增加(P＜0.05),2组患者生命体征指标无显著变化(P＞0.05);2组患者PCT、LPS、LE、Lac、PEEP、Raw水平显著降低(P＜0.05),且B组低于A组(P＜0.05);2组患者PaO2/FiO2、CA、Cdyn水平显著增加(P＜0.05),且B组高于A组(P＜0.05);2组不良反应无显著差异(P＞0.05).结论 西维来司他钠联合乌司他丁治疗ARDS效果显著,可有效改善患者生命体征指标、炎性水平、血气指标和肺功能.
Abstract
Objective To detect the effect of sivelestat sodium combined with ulinastatin on inflammatory response and blood gas in patients with acute respiratory distress syndrome(ARDS).Methods A total of 202 ARDS patients admitted in our hospital from May 2021 to March 2023 were enrolled.According to the coin toss methods,patients were assigned into group A(n=101,treatment of ulinastatin)and group B(n=101,treatment of sivelestat sodium combined with ulinastatin).Vital signs(blood pressure,heart rate,body temperature,respiration),inflammatory response(procalcitonin[PCT],lipopolysaccharide[LPS],lysosomal enzyme[LE]),blood gas(oxygenation index[PaO2/FiO2],blood lactic acid[Lac],active carbonic anhydrase[CA]),pulmonary function(dynamic lung compliance[Cdyn],positive end expiration pressure[PEEP],airway resistance[Raw])and adverse events were compared between groups.Results After treatment,significantly decreased heart rate,temperature and respiratory rate,and significantly increased blood pressure were detected in both groups(P＜0.05).No significant differences in the vital signs after treatment were detected between groups(P＞0.05).PCT,LPS,LE,Lac,PEEP and Raw were significantly decreased in both groups after treatment,which were significantly lower in group B than those of Group A(P＜0.05).PaO2/FiO2,CA and Cdyn were significantly increased in both groups after treatment,which were significantly higher in group B than those of Group A(P＜0.05).No significant difference in the incidence of adverse events was detected between groups(P＞0.05).Conclusion Sivelestat sodium combined with ulinastatin offers an excellent therapeutic efficacy on ARDS,which greatly improve vital signs,inflammatory response,blood gas and pulmonary function.
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