乌司他丁对急性呼吸窘迫综合征患者凝血功能的影响  

Effects of ulinastatin on blood coagulation in patients with acute respiratory distress syndrome

作　　者：季明霞[1] 斯小水[1] 何建新[1] 刘宏革[1] 陈梦燕[1] 王娇[1] 黄静[1] 郑文娟[1] 朱黎君 

机构地区：[1]义乌市中心医院重症医学科,322000

出　　处：《浙江医学》2014年第24期2003-2005,共3页Zhejiang Medical Journal

基　　金：义乌市科研计划项目(13-3-30);义乌市医学重点学科建设资助(13-ZD03)

摘　　要：目的探讨乌司他丁对急性呼吸窘迫综合征(ARDS)患者凝血功能的影响。方法将80例ARDS患者按随机数字表法分为治疗组和对照组,各40例。对照组给予机械通气、抗感染、营养支持治,治疗组在此基础上加用乌司他丁针10万U+0.9%氯化钠溶液100ml静脉滴注3次/d,连续7d。比较两组患者住ICU时间、机械通气时间、28d病死率以及治疗前后急性生理学与慢性健康状况Ⅱ(APACHEⅡ)评分、氧合指数、血浆凝血酶原时间(PT)、纤维蛋白原(FIB)和D-二聚体(D-D)水平及血小板计数(Plt)变化。结果治疗组住ICU时间、28d病死率、APACHEⅡ评分均低于对照组(均P<0.05),氧合指数、FIB、Plt水平均高于对照组(均P<0.05),PT、D-D水平治疗后低于对照组(均P<0.05)。结论在常规治疗的基础上,应用乌司他丁治疗能改善ARDS患者的凝血功能及炎症指标,缩短机械通气时间、入住ICU时间,降低病死率。Objective To investigate the effects of ulinastatin on blood coagulation in patients with acute respiratory dis-tress （ARDS）. Methods Eighty ARDS patients were randomly divided into treatment group（n=40） and control group（n=40）. Pa-tients in both groups received mechanical ventilation, anti- infection and nutritional support;patients in treatment group received ulinastatin injection 100,000U, q.8.h for 7d. The length of ICU stay, duration of mechanical ventilation, 28- d mortality, the A-PACHE II scores before and after treatment, oxygenation index （PaO2 / FiO2）, plasma prothrombin time （PT）, fibrinogen （Fib）, D- dimer （D- D） concentration and platelet count（Plt） were compared between two groups. Results In the treatment group, the length of ICU stay, the 28- d mortality rate, APACHEⅡsccores were lower than those of control group （P〈0.05）;the oxygena-tion index, Fib and Plt were higher than those of the control group（P〈0.05）;the PT and D- D concentrations after treatment were lower than those in control group （P〈0.05）. Conclusion Administration of ulinastatin on the basis of routine treatment can im-prove the function of blood coagulation and the inflammatory index, shorten the duration of mechanical ventilation, ICU stay time and reduce mortality in patients with acute respiratory distress syndrome.

关 键 词：乌司他丁 凝血功能 急性呼吸窘迫综合征 

分 类 号：R563.8[医药卫生—呼吸系统]