乌司他丁联合地塞米松治疗创伤性肺损伤对患者血清一氧化氮及内皮素的影响(1)
【摘要】 目的：观察乌司他丁联合地塞米松治疗创伤性肺损伤对患者血清中一氧化氮(NO)和内皮素(ET-1)的影响。方法：选取2014年1月-2015年1月本院收治的52例创伤所致肺损伤住院患者作为研究对象，采用随机数字表法将其分为观察组与对照组，每组26例，对照组在常规治疗基础上接受地塞米松治疗，观察组在对照组治疗基础上联合乌司他丁治疗。记录并比较两组机械通气使用率、呼吸窘迫综合征(ARDS)发生率，检测比较两组不同时间肺泡-动脉氧分压差(PA-aDO2)、氧和分数(PaO2/FiO2)、动脉氧分压(PaO2)及患者血清NO、ET-1浓度。结果：观察组ARDS发生率及机械通气使用率均低于对照组，比较差异均有统计学意义(P<0.05)；治疗第5天，两组PaO2、PaO2/FiO2均高于治疗前，而PA-aDO2及NO、ET-1浓度均低于治疗前，观察组PaO2、PaO2/FiO2、NO及ET-1均优于对照组，比较差异均有统计学意义(P<0.05)。结论：乌司他丁联合地塞米松治疗创伤性肺损伤疗效显著，能够有效改善患者氧合状况，降低患者炎症反应发生率以及机械通气使用率。
, 百拇医药
【关键词】 机械通气； 一氧化氮； 内皮素-1； 乌司他丁； 地塞米松
【Abstract】 Objective：To investigate the combined effects of Ulinastatin and Dexamethasone on serum levels of nitric oxide(NO) and endothelin-1(ET-1) in patients with traumatic lung injury.Method：52 patients with traumatic lung injury in our hospital from January 2014 to January 2015 were selected and randomly divided into the observation group and the control group，each group had 26 patients.Patients in the control group received extra Dexamethasone on the basis of traditional treatment while patients in the observation group received Ulinastatin on the basis of the control group.Mechanical ventilation rate and incidence rate of acute respiratory distress syndrome(ARDS) were recorded and compared between the two groups.The PA-aDO2，PaO2/FiO2，PaO2 and the levels of NO and ET-1 were analyzed and compared.Result：The mechanical ventilation rate and the incidence rate of ARDS in the observation group were lower than those in the control group，the differences were statistically significant(P<0.05).After 5 days of treatment，the PaO2 and PaO2/FiO2 of the two groups were all higher than before treatment，the PA-aDO2 and the levels of NO and ET-1 of the two groups were lower than before treatment，the PaO2，PaO2/FiO2 and the levels of NO and ET-1 of the observation group were better than those of the control group，the differences above were all statistically significant(P<0.05).Conclusion：Ulinastatin combined with Dexamethasone in the treatment of traumatic lung injury can significantly improve the treatment effects and patients’ oxygenation status，thus reduce the incidence rate of inflammation and the utilization rate of mechanical ventilation.
, 百拇医药
【Key words】 Mechanical ventilation； Nitric oxide； Endothelin-1； Ulinastatin； Dexamethasone
First-author’s address：Traditional Chinese Medical Hospital of Gaomi City，Gaomi 261500，China
doi：10.3969/j.issn.1674-4985.2015.32.025
呼吸窘迫综合征(ARDS)是创伤患者临床较为严重的并发症之一，主要以肺微血管通透性增加引发患者弥漫性肺间质以及肺泡腔水肿致低氧血症发生为主，情况严重时会引发多脏器功能障碍[1-4]。Liu等[5]研究认为，患者ARDS发病过程中，肺内过度、失控性炎症反应以及氧化应激所导致的氧化损伤起关键作用。因此，选择有效药物控制患者炎症反应对ARDS患者的预防和治疗有着极为重要的意义。乌司他丁能够通过抑制炎症介质的释放、细胞因子的级联反应，降低多种蛋白酶对机体组织器官造成的影响和损伤。地塞米松具有较强的抗炎以及抗渗作用，虽然地塞米松、乌司他丁在ARDS的临床治疗中应用较为广泛，但有关两药联合应用的文献报道较少，本研究对52例创伤患者实施乌司他丁联合地塞米松治疗，旨在研究乌司他丁联合地塞米松对创伤性肺损伤患者氧交换指标以及炎症标记物NO及ET-1浓度的影响，现报道如下。, 百拇医药(王庆秀 刘萃 王庆亮)
, 百拇医药
【关键词】 机械通气； 一氧化氮； 内皮素-1； 乌司他丁； 地塞米松
【Abstract】 Objective：To investigate the combined effects of Ulinastatin and Dexamethasone on serum levels of nitric oxide(NO) and endothelin-1(ET-1) in patients with traumatic lung injury.Method：52 patients with traumatic lung injury in our hospital from January 2014 to January 2015 were selected and randomly divided into the observation group and the control group，each group had 26 patients.Patients in the control group received extra Dexamethasone on the basis of traditional treatment while patients in the observation group received Ulinastatin on the basis of the control group.Mechanical ventilation rate and incidence rate of acute respiratory distress syndrome(ARDS) were recorded and compared between the two groups.The PA-aDO2，PaO2/FiO2，PaO2 and the levels of NO and ET-1 were analyzed and compared.Result：The mechanical ventilation rate and the incidence rate of ARDS in the observation group were lower than those in the control group，the differences were statistically significant(P<0.05).After 5 days of treatment，the PaO2 and PaO2/FiO2 of the two groups were all higher than before treatment，the PA-aDO2 and the levels of NO and ET-1 of the two groups were lower than before treatment，the PaO2，PaO2/FiO2 and the levels of NO and ET-1 of the observation group were better than those of the control group，the differences above were all statistically significant(P<0.05).Conclusion：Ulinastatin combined with Dexamethasone in the treatment of traumatic lung injury can significantly improve the treatment effects and patients’ oxygenation status，thus reduce the incidence rate of inflammation and the utilization rate of mechanical ventilation.
, 百拇医药
【Key words】 Mechanical ventilation； Nitric oxide； Endothelin-1； Ulinastatin； Dexamethasone
First-author’s address：Traditional Chinese Medical Hospital of Gaomi City，Gaomi 261500，China
doi：10.3969/j.issn.1674-4985.2015.32.025
呼吸窘迫综合征(ARDS)是创伤患者临床较为严重的并发症之一，主要以肺微血管通透性增加引发患者弥漫性肺间质以及肺泡腔水肿致低氧血症发生为主，情况严重时会引发多脏器功能障碍[1-4]。Liu等[5]研究认为，患者ARDS发病过程中，肺内过度、失控性炎症反应以及氧化应激所导致的氧化损伤起关键作用。因此，选择有效药物控制患者炎症反应对ARDS患者的预防和治疗有着极为重要的意义。乌司他丁能够通过抑制炎症介质的释放、细胞因子的级联反应，降低多种蛋白酶对机体组织器官造成的影响和损伤。地塞米松具有较强的抗炎以及抗渗作用，虽然地塞米松、乌司他丁在ARDS的临床治疗中应用较为广泛，但有关两药联合应用的文献报道较少，本研究对52例创伤患者实施乌司他丁联合地塞米松治疗，旨在研究乌司他丁联合地塞米松对创伤性肺损伤患者氧交换指标以及炎症标记物NO及ET-1浓度的影响，现报道如下。, 百拇医药(王庆秀 刘萃 王庆亮)