乌司他丁治疗慢性阻塞性肺疾病急性加重期的临床疗效  

Clinical observation of ulinastatin injection in treating acute exacerbation of chronic obstructive pulmonary disease

作　　者：隋晓俊[1] 康军阳[1] 宫艳飞[1] 

机构地区：[1]威海市文登中心医院ICU,264400

出　　处：《国际呼吸杂志》2009年第13期777-779,共3页International Journal of Respiration

摘　　要：目的探讨乌司他丁治疗慢性阻塞性肺疾病急性加重期的临床疗效和部分作用机制。方法对符合慢性阻塞性肺疾病急性加重期诊断标准的72例患者，随机分为乌司他丁治疗组和对照组，各36例，两组均予常规治疗，治疗组在此基础上加用乌司他丁20万u，静脉注射，3次／d，连用7d。结果治疗组总有效率为86．11％，明显优于对照组69．44％（P〈0．05），治疗组在改善APACHEⅡ评分、血气分析方面明显优于对照组，且能显著降低C反应蛋白、肿瘤坏死因子α、白介素8含量，明显缩短患者机械通气及入住重症监护病房时间（P〈0．05）。结论慢性阻塞性肺疾病急性加重期在常规治疗的基础上加用乌司他丁有较好的临床疗效，其作用机制可能在于通过抑制炎症介质和细胞因子的释放，减轻炎症反应，舒张平滑肌、改善患者的通气功能和血液流变学指标。Objective To discuss the effect of ulinastatin on chronic obstructive pulmonary disease with acute exacerbation and part of the mechanism. Methods Seventy-two cases consistent with the diagnostic criteria were randomly divided into ulinastatin statin therapy group and control group （36 cases each group）, two groups both received conventional treatment, the treatment group on this basis was added ulinastatin with 200 000 U, intravenous injection, three times a day. Results In the treatment group the total effective rate was 86.11%, significantly better than in the control group 69.44% （P 〈0.05）, its improvement in APACHE 11 score, blood gas analysis and reduction in CRP, TNF-α, IL-8 was superior to the control group. The treatment group was significantly shorter than the control group in mechanical ventilation and ICU stay time （ P 〈0.05）. Conclusions Conventional therapy as basis plus ulinastatin has better clinical efficacy, for whose chronic obstructive pulmonary disease with acute exacerbation mechanism may lie in the inhibition of inflammatory mediators and cytokines release, reducing inflammation, relaxing smooth muscle,improving the patient＇s ventilatory function and blood rheology.

关 键 词：慢性阻塞性肺疾病 乌司他丁 肿瘤坏死因子Α 白介素8 

分 类 号：R563.9[医药卫生—呼吸系统]