注射用乌司他丁联合参附注射液对老年急性呼吸窘迫综合征患者的影响

摘要

目的 探讨注射用乌司他丁联合参附注射液对老年急性呼吸窘迫综合征(ARDS)患者的影响.方法 选取2016年武汉市武昌医院收治的老年ARDS患者76例,按照治疗方法不同分为对照组和观察组,每组38例.在常规治疗基础上,对照组患者给予注射用乌司他丁治疗,观察组患者在对照组基础上加用参附注射液治疗;两组患者均连续治疗1周.比较两组患者治疗前后急性生理学与慢性健康状况评价系统Ⅱ(APACHEⅡ)评分、Murray肺损伤评分、器官功能障碍(SOFA)评分、血气分析指标、血清炎性因子水平,并观察两组患者治疗期间不良反应发生情况.结果 治疗前两组患者APACHEⅡ评分、Murray肺损伤评分、SOFA评分比较,差异无统计学意义(P＞0.05);治疗后观察组患者APACHEⅡ评分、Murray肺损伤评分、SOFA评分低于对照组(P＜0.05).治疗前两组患者动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、氧合指数比较,差异无统计学意义(P＞0.05);治疗后观察组患者PaO2、氧合指数高于对照组,PaCO2低于对照组(P＜0.05).治疗前两组患者血清白介素6(IL-6)、肿瘤坏死因子α(TNF-ot)、超敏C反应蛋白(hs-CRP)水平比较,差异无统计学意义(P＞0.05);治疗后观察组患者血清IL-6、hs-CRP、TNF-α水平低于对照组(P＜0.05).两组患者治疗期间均未发生严重不良反应.结论 注射用乌司他丁联合参附注射液可有效缓解老年ARDS患者临床症状,调节血气分析指标并降低血清炎性因子水平,且安全性较高.%Objective To investigate the impact of ulinastatin for injection combined with shenfu injection on senile patients with acute respiratory distress syndrome (ARDS).Methods A total of 76 senile patients with ARDS were selected in Wuchang Hospital of Wuhan in 2016,and they were divided into control group and observation group according to therapeutic methods,each of 38 cases.Based on conventional treatment,patients of control group received ulinastatin for injection,while patients of observation group received ulinastatin for injection combined with shenfu injection;both groups continuously treated for 1 week.APACHE Ⅱ score,Murray lung injury score,SOFA score,blood-gas analysis results,serum inflammatory cytokines levels before and after treatment were compared between the two groups,and incidence of adverse reactions was observed during the treatment.Results No statistically significant differences of APACHE Ⅱ score,Murray lung injury score or SOFA score was found between the two groups before treatment (P ＞ O.05),while APACHE Ⅱ score,Murray score and SOFA score of observation group were statistically significantly lower than those of control group after treatment (P ＜ O.05).No statistically significant differences of PaO2,PaCO2 or oxygenation index was found between the two groups before treatment (P ＞ 0.05);after treatment,PaO2 and oxygenation index of observation group were statistically significantly higher than those of control group,while PaCO2 of observation group was statistically significantly lower than that of control group (P ＜ 0.05).No statistically significant differences of serum level of IL-6,TNF-α or hs-CRP was found between the two groups before treatment (P ＞ 0.05),while serum levels of IL-6,hs-CRP and TNF-α of observation group were statistically significantly lower than those of control group after treatment (P ＜ 0.05).No one of the two groups occurred any serious adverse reactions during the treatment.Conclusion Ulinastatin for injection combined with shenfu injection can effectively relieve the clinical symptoms of senile patients with ARDS,adjust the blood-gas and reduce the serum inflammatory cytokines levels,and is relatively safe.