目的 探讨儿童使用西维来司他钠治疗脓毒症和急性呼吸窘迫综合征的安全性和有效性.方法 回顾性收集空军军医大学第一附属医院儿科重症监护室2021年1月至2024年7月收治的使用西维来司他钠的重症患儿的资料,并以"西维来司他钠"、"脓毒症"、"急性呼吸窘迫综合征"和"儿童"为中文检索词检索知网、万方和维普等数据库,以"Sivelestat sodium"、"Sepsis"、"Respiratory distress syndrome"和"Child"为英文检索词检索PubMed、Embase、Web of Science数据库,检索日期截至2024年7月30日.结果 共收集到9例病例,其中我院6例,文献报道3例,年龄中位数为4岁5个月,男性5例(55.6％).9例患儿中,5例在用药后白细胞计数(WBC)、降钙素原(PCT)和白介素-6(IL-6)较前明显好转,3例C反应蛋白(CRP)明显改善;4例患有脓毒症患儿用药后PCT均明显改善,其中3例IL-6明显改善,2例WBC明显下降.在7例患有急性呼吸窘迫综合征或呼吸衰竭的患儿中,有2例在用药后氧合指数(PaO2/FiO2)明显改善.结论 西维来司他钠有助于降低WBC、IL-6、PCT和CRP的水平,抑制重症患儿者体内炎症反应,有助于改善急性呼吸窘迫患儿PaO2/FiO2比值.
Case analysis and literature review of sivelestat sodium in the treatment of sepsis and respiratory distress syndrome in children
Objective To investigate the safety and efficacy of sivelestat sodium in the treatment of sepsis and acute respiratory distress syndrome in children.Methods Data of critically ill children treated with cilvelestat sodium in the Pediatric Intensive Care Unit of the First Affiliated Hospital of Air Force Medical University from January 2021 to July 2024 were retrospectively collected.In addition,"Sivelestat sodium","Sepsis","Acute respiratory distress syn-drome"and"Child"were used as search terms to search CNKI,Wanfang,WIP,PubMed,Embase and Web of Science databases(until July 30,2024).Results A total of 9 pediatric patients were collected,including 6 cases in our hospital and 3 cases reported in the literatures.The median age of the children was 4 years and 5 months,and 5 cases(55.6％)were male.The white blood cell(WBC)count,procalcitonin(PCT)and interleukin-6(IL-6)were significantly im-proved in 5 cases,and C-reactive protein(CRP)was significantly improved in 3 cases.PCT was significantly improved in 4 patients with sepsis,IL-6 was significantly improved in 3 cases,and WBC count was significantly decreased in 2 cases.There were 7 children with acute respiratory distress syndrome or respiratory failure,in which,oxygenation index(PaO2/FiO2)of 2 cases was improved significantly after medication.Conclusion Sivelestat sodium can reduce WBC,IL-6,PCT and CRP,inhibit inflammation in critically ill children,and improve PaO2/FiO2 ratio in children with acute re-spiratory distress syndrome.
万方数据
维普
