乌司他丁联合血必净注射液治疗老年重症肺炎的临床效果  

Clinical Study on Ulinastatin Injection Combined with Xuebijing Injection in Treatment of Elderly Patients with Severe Pneumonia

作　　者：曹学雷[1] 黄欢[1] 孙晓红[1] 秦桥基[1] 

机构地区：[1]青岛大学附属医院急诊科,山东青岛266000

出　　处：《医学综述》2016年第20期4136-4138,4142,共4页Medical Recapitulate

摘　　要：目的观察并探讨乌司他丁联合血必净注射液治疗老年重症肺炎的临床疗效。方法入选2013年6月至2015年4月青岛大学附属医院急诊科收治的重症肺炎患者96例,根据随机数字表法分为联合组(49例)与对照组(47例)。两组患者均给予综合对症治疗,对照组加用血必净注射液,100 m L血必净注射液加入200 m L 0.9%Na Cl注射液静脉滴注,每日2次,联合组在对照组基础上加用乌司他丁注射液,20万U乌司他丁加入50 m L 0.9%Na Cl注射液微量泵泵注,每日2次,疗程均为14 d,记录病死情况与有创通气比例,对比治疗前后动脉血气指标与外周血炎性介质浓度,比较临床疗效。结果联合组治疗后动脉血氧分压、动脉血二氧化碳分压、氧合指数均显著优于对照组[(98±10)mm Hg(1 mm Hg=0.133 k Pa)比(92±9)mm Hg,(41±4)mm Hg比(43±3)mm Hg,(283±40)比(243±37),P<0.01]。联合组治疗后肿瘤坏死因子α、白细胞介素6、白细胞介素8、C反应蛋白均显著低于对照组[(22±8)ng/L比(38±12)ng/L、(56±15)ng/L比(68±17)ng/L、(59±10)ng/L比(69±11)ng/L、(12±3)mg/L比(17±5)mg/L,P<0.01]。联合组与对照组治疗中行有创通气比例、病死率差异无统计学意义(P>0.05);联合组与对照组总有效率比较差异无统计学意义(P>0.05)。结论血必净与乌司他丁在重症肺炎抗炎治疗中作用协同,联合应用较之单纯应用血必净注射液可进一步抑制炎症反应,改善肺氧合功能,改善治疗效果。Objective To observe and explore clinical efficacy of ulinastatin injection（UTI） combined with Xuebijing injection in treatment of elderly patients with severe pneumonia. Methods Total of 96 severe pneumonia patients in the Affiliated Hospital of Qingdao University from Jun. 2013 to Apr. 2015 were selected and assigned as a combination group（49 cases） and a control group（47 cases） according to the random number table method. All patients were given symptomatic treatment, the control group was added with Xuebijing injection,100 mL of Xuebijing injection added into 200 mL of 0. 9% NaCl injection for intravenous drip,bid, ,based on which the combination group was added with UTI injection,200 000 U UTI added into 50 mL of 0. 9% NaCl injection for trace injection pump, bid, treatment course was lg days for both groups,the mortality rate and invasive ventilation ratio were noted, and arterial blood gas index and peripheral blood medium concentrations were compared before and after treatment, besides, the clinical efficacies were determined. Results After treatment the PaO2 （98± 10） mmHg vs （92 ± 9 ） mmHg, PaCO2 （41 ± 4 ） mmHg vs （43 ±3 ） mmHg, PaO2/FiO2 （ 283 ±40） vs （ 243 ± 37 ） of the observation group were significantly better than the control group（P 〈0. 05）. The TNF-α（22 ±8） ng/L vs （38 ± 12） ng/L,IL-6（56 ± 15） ng/ L vs （68 ±17） ng/L, IL-8 （59± 10） ng/L vs （69 ±11 ） ng/L, C reactive protein （ 12±3 ） mg/L vs （ 17 ± 5 ） mg/L of the observation group were all significantly lower than the control group（ P 〈 0. 01 ）. The differences on invasive ventilation ratio, mortality rate between the two groups had no statistically significant difference （ P 〉 0. 05 ） ; total efficacy of the two groups had no statistically significance difference（ P 〉 0. 05 ）. Condusion Xuebijing injection and UTI injection have synergism in anti-inflammatory treatment of severe pneumonia,combination of Xuebijing and UTI injection compared w

关 键 词：重症肺炎 乌司他丁 血必净注射液 氧合功能 炎性介质 肺损伤 

分 类 号：R563.19[医药卫生—呼吸系统]