乌司他丁辅助治疗对老年重症肺炎患者肺功能、炎症因子及血清CD40L表达的影响  

Effects of ulinastatin on lung function,inflammatory factors and serum CD40L expression in elderly patients with severe pneumonia

作　　者：胡辉荣 苏娴[1] 王月宾[1] 严方涛 陈鹏 HU Hui-rong;SU Xian;WANG Yue-bin(Department of Respiratory and Critical Care Medicine,Chengdu Third People's Hospital,Chengdu Sichuan 610014,China)

机构地区：[1]成都市第三人民医院呼吸与危重症医学科,四川成都610014

出　　处：《临床和实验医学杂志》2023年第9期922-926,共5页Journal of Clinical and Experimental Medicine

基　　金：四川省自然科学基金项目(编号:20F200836)。

摘　　要：目的研究乌司他丁辅助治疗对老年重症肺炎患者肺功能、炎症因子及血清CD40L表达的影响。方法以回顾性分析为法,观察对象为2020年1月至2022年1月入成都市第三人民医院的60例老年重症肺炎患者,参考治疗方式分为对照组(30例)与研究组(30例)。对照组仅行常规治疗,研究组在常规治疗基础上联用乌司他丁治疗。比较两组患者治疗前后肺功能指标[最高呼气流速(PEF)、用力肺活量(FVC)、第1秒最大呼吸容积(FEV1)]、炎症因子[降钙素原、白细胞介素-6(IL-6)、C反应蛋白(CRP)]、肺氧合功能指标[动脉血氧分压(PaO_(2))、氧合指数(PaO_(2)/FiO_(2))]、血清T细胞CD40配体(CD40L)、血管细胞黏附分子-1(VACM-1)水平与治疗总有效率。结果治疗后,两组患者的PEF、FVC、FEV1、PaO_(2)、PaO_(2)/FiO_(2)均明显高于治疗前,降钙素原、IL-6、CRP、CD40L、VACM-1水平均明显低于治疗前,差异均有统计学意义(P<0.05);研究组患者治疗后PEF、FVC、FEV1、PaO_(2)、PaO_(2)/FiO_(2)分别为(2.87±0.42)L/s、(3.01±0.19)L、(2.24±0.25)L、(2.87±0.42)mmHg、290.04±19.92、(2.24±0.25)L,均明显高于对照组[(2.32±0.37)L/s、(2.43±0.22)L、(1.81±0.23)L、(2.32±0.37)mmHg、231.35±13.39],降钙素原、IL-6、CRP、CD40L、VACM-1水平分别为(4.73±1.32)μg/L、(23.09±5.52)ng/L、(12.41±3.46)mg/L、(1.42±0.31)ng/mL、(469.03±16.65)ng/mL,均明显低于对照组[(9.05±1.74)μg/L、(50.07±9.86)ng/L、(26.74±5.78)mg/L、(2.24±0.42)ng/mL、(526.09±21.14)ng/mL],差异均有统计学意义(P<0.05)。研究组患者治疗后总有效率为96.67%,明显高于对照组(73.33%),差异有统计学意义(P<0.05)。结论乌司他丁辅助治疗老年重症肺炎患者的疗效显著,可有效改善患者肺功能及肺氧合功能,还可进一步减轻炎症反应,降低CD40L、VACM-1水平,促进患者快速康复。Objective To study the effect of ulinastatin adjuvant therapy on lung function,inflammatory factors and serum CD40L expression in elderly patients with severe pneumonia.Methods A retrospective analysis was conducted to observe 60 elderly patients with severe pneumonia admitted to Chengdu Third People's Hospital from January 2020 to January 2022.According to the treatment methods,they were divided into the control group(30 cases)and the study group(30 cases).The control group only received routine treatment,while the study group received combined treatment with ulinastatin on the basis of routine treatment.The pulmonary function indexes[peak expiratory flow rate(PEF),forced vital capacity(FVC),maximum respiratory volume in the first second(FEV1)],inflammatory factors[procalcitonin(PCT),interleukin-6(IL-6),C-reactive protein(CRP)],pulmonary oxygenation function indexes[arterial partial pressure of oxygen(PaO_(2)),oxygenation index]were compared between the two groups before and after treatment(PaO_(2)/FiO_(2)),serum T cell CD40 ligand(CD40L),vascular cell adhesion molecule-1(VCAM-1)levels and the total effective rate after treatment.Results After treatment,PEF,FVC,FEV1,PaO_(2),PaO_(2)/FiO_(2) in the two groups were significantly higher than those before treatment,and PCT,IL-6,CRP,CD40L,VCAM-1 levels were significantly lower than those before treatment,and the differences were statistically significant(P<0.05);after treatment,PEF,FVC,FEV1,PaO_(2),PaO_(2)/FiO_(2) in the study group were(2.87±0.42)L/s,(3.01±0.19)L,(2.24±0.25)L,(2.87±0.42)mmHg,290.04±19.92,(2.24±0.25)L,respectively,which were significantly higher than those in the control group[(2.32±0.37)L/s,(2.43±0.22)L,(1.81±0.23)L,(2.32±0.37)mmHg,231.35±13.39],the levels of procalcitonin,IL-6,CRP,CD40L,VACM-1 were(4.73±1.32)μg/L,(23.09±5.52)ng/L,(12.41±3.46)mg/L,(1.42±0.31)ng/mL,(469.03±16.65)ng/mL,respectively,which were significantly lower than those in the control group[(9.05±1.74)μg/L,(50.07±9.86)ng/L,(26.74±5.78)mg/L,(2.24±0.42)ng/mL,(526

关 键 词：老年 重症肺炎 乌司他丁 肺功能 炎症因子 肺氧合功能 

分 类 号：R563.1[医药卫生—呼吸系统]