不同剂量乌司他丁对轻中度急性呼吸窘迫综合征的临床疗效

摘要

Objective To observe clinical effects of different doses of Ulinastatin in treatment of patients with mild and moderate acute respiratory distress syndrome (ARDS).Methods A total of 60 patients with mild and moderate ARDS admitted during June 2014 and June 2016 were divided into control group (n=20),low dose group (n=20) and high dose group (n=20) according to random digits table.All patients received conventional therapy,and then low and high dose groups were added with 100,000U and 300,000U (TID) Ulinastatin by iv gtt (3/d for continuous 7d).Values of oxygenation indexes were recorded,and acute physiology and chronic health evaluation (APACHEⅡ) scores were detected before treatment and on the 8th d of treatment,and mortality on the 28thd after treatment,ICU mortality and the length of ICU stay were also calculated.Results There were no significant differences in oxygenation indexes and APACHEⅡ scores among the three groups before treatment (P>0.05).After treatment,oxygenation indexes were significantly increased,and APACHEⅡ scores were significantly decreased among three group (P0.05).Compared with those in control group,values of mortality on the 28thd after treatment,ICU mortality and the length of ICU stay were significantly decreased in low and high dose groups after treatment (P0.05).Conclusion Ulinastatin can improve oxygenation condition,decrease APACHEⅡ scores and mortality on the 28th d and ICU mortality and shorten the length of ICU stay in patients with mild and moderate ARDS.%目的 观察不同剂量乌司他丁治疗轻中度急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)的临床效果.方法 选取2014年6月-2016年6月我院收治的ARDS 60例,按照随机数字表法分为对照组、低剂量组及高剂量组,每组各20例.三组均予常规治疗,在此基础上低剂量组、高剂量组分别予10万单位、30万单位乌司他丁静脉滴注、3/d,连用7 d,分别于治疗前及治疗第8天记录各组的氧合指数,并进行急性生理和慢性健康(APACHEⅡ)评分,计算28 d病死率、重症监护病房(ICU)病死率及ICU住院时间.结果 治疗前各组氧合指数、APACHEⅡ评分比较差异无统计学意义(P>0.05);治疗后各组氧合指数较治疗前均显著升高(P0.05).与对照组比较,低剂量组和高剂量组28 d病死率、ICU病死率及ICU住院时间均显著降低(P0.05).结论 乌司他丁可改善轻中度ARDS患者的氧合状态,降低APACHEⅡ评分、28 d病死率及ICU死亡率,减少ICU住院时间.