[1]刘广精,王光权,黎天皇.乌司他丁联合依诺肝素治疗脓毒症并发急性肺损伤临床疗效及安全性研究[J].陕西医学杂志,2023,52(8):1071-1075.[doi:DOI:10.3969/j.issn.1000-7377.2023.08.030]
　LIU Guangjing,WANG Guangquan,LI Tianhuang.Clinical efficacy and safety of ulinastatin combined with enoxaparin in treatment of sepsis complicated with acute lung injury[J].,2023,52(8):1071-1075.[doi:DOI:10.3969/j.issn.1000-7377.2023.08.030]
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乌司他丁联合依诺肝素治疗脓毒症并发急性肺损伤临床疗效及安全性研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
52
期数:
2023年8期
页码:
1071-1075
栏目:
药物与临床
出版日期:
2023-08-05

文章信息/Info

Title:
Clinical efficacy and safety of ulinastatin combined with enoxaparin in treatment of sepsis complicated with acute lung injury
作者:
刘广精; 王光权; 黎天皇
(琼海市人民医院,海南 琼海 571400)
Author(s):
LIU Guangjing; WANG Guangquan; LI Tianhuang
(Qionghai People's Hospital,Qionghai 571400,China)
关键词:
乌司他丁;  依诺肝素;  脓毒症;  急性肺损伤;  急性呼吸窘迫综合征;  肺功能
Keywords:
Ulinastatin;  Enoxaparin;  Sepsis;  Acute lung injury;  Acute respiratory distress syndrome;  Pulmonary function
分类号:
R 631
DOI:
DOI:10.3969/j.issn.1000-7377.2023.08.030
文献标志码:
A
摘要:
目的:探讨乌司他丁联合依诺肝素在脓毒症并发急性肺损伤患者治疗中的应用价值。方法:选取118例脓毒症并发急性肺损伤患者为研究对象,根据治疗方法不同分为对照组、乌司他丁组和乌司他丁+依诺肝素组三组。对照组采用常规方法治疗,乌司他丁组和乌司他丁+依诺肝素组在对照组常规方法治疗的基础上分别给予乌司他丁和乌司他丁联合依诺肝素治疗。观察三组患者治疗前后呼吸功能指标血氧分压(PaO2)、氧合指数(PaO2/FiO2)、肺血管外肺水指数(ELWI)、血清炎症因子白细胞介素 6(IL-6)、肿瘤坏死因子α(TNF-α)、C 反应蛋白(CRP)和降钙素原(PCT)水平、肺损伤预测评分(LIPS)、急性生理和慢性健康状况(APACE Ⅱ)评分、全身性感染相关性器官功能衰竭(SOFA)评分和视觉模拟疼痛评分(VAS)以及疗效。结果:对照组、乌司他丁组和乌司他丁+依诺肝素组呼吸功能指标PaO2、PaO2/FiO2均较治疗前升高,且乌司他丁+依诺肝素组显著高于对照组和乌司他丁组,而ELWI则均较治疗前显著下降(P<0.05)。对照组、乌司他丁组和乌司他丁+依诺肝素组炎症因子水平IL-6、TNF-α、CRP和PCT,肺功能相关评分LIPS评分、APACHE Ⅱ评分、SOFA评分和VAS评分均较治疗前显著降低,且乌司他丁+依诺肝素组显著低于对照组和乌司他丁组,组间比较差异均有统计学意义(均P<0.05)。乌司他丁+依诺肝素组的总有效率(97.0%)显著高于对照组(82.0%)和乌司他丁组(88.0%),而发生急性呼吸窘迫综合征(ARDS)、使用有创机械通气和28 d病死率均显著低于对照组和乌司他丁组(均P<0.05)。结论:乌司他丁联合依诺肝素可改善脓毒症并发急性肺损伤患者肺功能和凝血异常,减轻炎性反应和疼痛,临床效果显著、安全性高。
Abstract:
Objective:To investigate the application value of ulinastatin combined with enoxaparin in the treatment of patients with sepsis complicated with acute lung injury.Methods:A total of 118 patients with sepsis complicated with acute lung injury were divided into control group,ulinastatin group and ulinastatin + enoxafparin group according to different treatment methods.Control group was treated with conventional treatment,while ulinastatin group and ulinastatin + enoxaparin group were treated with ulinastatin and ulinastatin combined with enoxaparin on the basis of conventional treatment in control group,respectively.Blood oxygen partial pressure(PaO2),Oxygenation Index(PaO2/FiO2),Pulmonary Extracascular Pulmonary Water Index(ELWI),serum inflammatory factor interleukin-6(IL-6),tumor necrosis factor α(TNF-α),C reactive protein(CRP)and procalcitonin(PCT)levels,Lung Injury Prediction Score(LIPS),Acute Physiological and Chronic Health Status Score Ⅱ(APACE Ⅱ),Sequential Organ Failure Assessment(SOFA)score,Visual Analogue Scale(VAS)score were observed before and after treatment.The efficacy was assessed.Results:The respiratory function indexes PaO2 and PaO2/FiO2 in the control group,ulinastatin group and ulinastatin + enoxaparin group were all higher than those before treatment,and the ulinastatin + enoxaparin group was significantly higher than the control group and ulinastatin group,and ELWI was significantly decreased compared with those before treatment(all P<0.05).The levels of IL-6,TNF-α,CRP and PCT in the control group,the ulinastatin group and the ulinastatin + enoxaparin group,the scores of LIS,APACHEⅡSOFA and VAS were significantly lower than those before treatment,and the ulinastatin + enoxaparin group was significantly lower than the control group and ulinastatin group(all P<0.05).The overall effective rate(97.0%)of the ulinastatin + enoxaparin group was significantly better than that of the control group(82.0%)and the ulinastatin group(88.0%),while the incidence of acute respiratory distress syndrome(ARDS),invasive mechanical ventilation and 28-day death were significantly lower than those in the control group and the ulinastatin group(all P<0.05).Conclusion: Ulinastatin combined with enoxaparin can improve pulmonary function and coagulation disorders,reduce inflammation and pain in patients with sepsis complicated with acute lung injury.

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备注/Memo

备注/Memo:
基金项目:海南省自然科学基金资助项目(822QN483)
更新日期/Last Update: 2023-08-07