摘要
目的探讨乌司他汀对神经源性肺水肿的疗效及对患者血清炎性因子、内皮素-1(ET-1)水平的影响。方法回顾性选取2012年3月～2017年12月张家口市第一医院收治的神经源性肺水肿患者246例,根据治疗方法不同分为对照组和观察组,每组123例。对照组患者采用常规治疗,观察组患者加用乌司他汀治疗,分析两组患者治疗后的临床效果。结果观察组患者平均撤机时间、抗生素使用时间短于对照组,病死率和多器官功能障碍综合征(MODS)发生率低于对照组,差异均有统计学意义(P <0.05)。治疗前,两组患者血管外肺水指数(EVLWI)、肺血管通透性指数(PVPI)水平比较,差异无统计学意义(P>0.05)。治疗1 d时,两组患者EVLWI、PVPI水平比较,差异无统计学意义(P> 0.05)。治疗3、7 d时,观察组患者EVLWI、PVPI水平低于对照组,差异有统计学意义(P <0.05)。治疗前,两组患者ET-1、肿瘤坏死因子α(TNF-α)水平比较,差异无统计学意义(P> 0.05)。治疗1、2、3 d时,观察组患者ET-1、TNF-α水平低于对照组,差异有统计学意义(P <0.05)。结论乌司他汀治疗神经源性肺水肿可缩短机械通气时间,减轻炎症反应,降低患者血清ET-1水平。
Objective To investigate the effect of ulinastatin on neurogenic pulmonary edema and the level of serum inflammatory factor endothelin-1 （ET-1）. Methods From March 2012 to December 2017,246 patients with neurogenic pulmonary edema were selected and divided into control group and observation group according to different treatment methods. The patients in the control group were treated with routine therapy,and the patients in the observation group were treated with ulinastatin. Results The mean time of withdrawal and antibiotic use were shorter in the observation group than in the control group ,and the mortality rate and the incidence of multi-organ dysfunction syndrome （MODS） were lower in the observation group than in the control group,with statistically significant differences（P 〈 0.05）. Before treatment,there was no statistically significant difference in the levels of EVLWl and PVPI between the two groups （P 〉 0.05）. On the first day of treatment,EVLWl and PVPI levels of the two groups were compared,and the difference was not statistically significant （P 〉 0.05）. On 3rd and 7^th days of treatment, EVLWl and PVPI levels of the observation group were lower than those of the control group,and the difference was statistically significant （P 〈 0.05）. Before treatment,there was no statistically significant difference in ET-1 and TNF- conditioning levels between the two groups （P 〉 0.05）. When treated for ld, 2d and 3d,the ET-1 and TNF- conditioning levels in the observation group were lower than those in the control group,and the difference was statistically significant （P 〈 0.05）. Conclusion Ulinastatin treatment of neurogenic pulmonary edema can shorten the time of mechanical ventilation, reduce inflammation and improve the level of ET-1 in patients.
作者
唐占军
吕超
侯霞
Tang Zhanjun;Lv Chao;Hou Xia(Department of Emergency,Zhangjiakou City First Hospital,Zhangjiakou 075000,China)
出处
《中华保健医学杂志》
2018年第5期403-405,共3页
Chinese Journal of Health Care and Medicine
关键词
乌司他汀
神经源性肺水肿
内皮素-1
炎症反应
Ulinastatin
Neurogenic pulmonary edema
Endothelin-1
Inflammatory response
