吸入性乙酰半胱氨酸联合乌司他丁治疗重症肺炎的临床疗效  

Observation of the Therapeutic Effects of Inhaled N-acetylcysteine Combined with Ustekinumab in the Treatment of Severe Pneumonia

作　　者：侯福建[1] 魏召辉 赵月伟[1] HOU Fujian;WEI Zhaohui;ZHAO Yuewei(Department of Respiratory Medicine,Dingzhou People's Hospital,Dingzhou Hebei 073000)

机构地区：[1]定州市人民医院呼吸内科,河北定州073000

出　　处：《医学临床研究》2024年第5期722-724,728,共4页Journal of Clinical Research

摘　　要：【目的】探讨吸入性乙酰半胱氨酸联合乌司他丁治疗重症肺炎的疗效。【方法】选取2021年3月至2023年3月本院收治的110例重症肺炎患者,按1∶1随机分为对照组(采用吸入性乙酰半胱氨酸联合抗感染治疗)和观察组(在对照组基础上联合乌司他丁治疗),每组55例,均治疗2周。比较两组临床疗效、退热时间、肺部啰音和咳嗽消失时间、不良反应发生率,以及炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]、血气分析指标[动脉血氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))和动脉血二氧化碳分压(PaCO_(2))]、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分。【结果】观察组总有效率为90.91%,显著高于对照组的76.36%,差异具有统计学意义(P<0.05)。观察组退热时间、肺部啰音和咳嗽消失时间均显著短于对照组(P<0.05)。观察组治疗2周后IL-6、TNF-α、CRP水平及PaCO_(2)低于对照组(P<0.05),PaO_(2)、SaO_(2)明显高于对照组(P<0.05)。治疗2周后,观察组生理评分、慢性健康状态评分均明显低于对照组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。【结论】吸入性乙酰半胱氨酸联合乌司他丁治疗重症肺炎患者疗效显著,能有效改善患者呼吸功能、减轻炎症反应,且不增加不良反应发生率,值得临床推广应用。【Objective】To investigate the curative effect of inhaled acetylcysteine combined with ulinastatin in the treatment of severe pneumonia.【Methods】A total of 110 patients with severe pneumonia admitted to our hospital from March 2021 to March 2023 were randomly divided into control group(receiving inhaled acetylcysteine combined with anti-infection treatment)and the observation group(receiving combined ulinastatin treatment on the basis of control group)with a ratio of 1∶1(55 cases in each group).All patients were treated for 2 weeks.The clinical efficacy,the time of fever reduction,the time of lung rales and cough disappearance,and the incidence of adverse reactions were compared between the two groups.Serum inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)],blood gas analysis indicators[PaO_(2),SaO_(2)and PaCO_(2)],acute physiology and chronic health status score SystemⅡ(APACHEⅡ)score were compared as well.【Results】The total effective rate of the observation group was 90.91%,which was significantly higher than 76.36%of the control group,and the difference was statistically significant(P<0.05).The time of fever reduction and disappearance of lung rales and cough in the observation group were significantly shorter than those in the control group(P<0.05).After 2 weeks of treatment,the levels of IL-6,TNF-α,CRP and PaCO_(2)in observation group were lower than those in control group(P<0.05),while PaO_(2)and SaO_(2)were significantly higher than those in control group(P<0.05).After 2 weeks of treatment,the physiological scores and chronic health status scores of the observation group were significantly lower than those of the control group,with statistical significance(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).【Conclusion】Inhaled acetylcysteine combined with ulinastatin is effective in the treatment of patients with severe pneumonia,which can effectively improve respiratory functio

关 键 词：肺炎/药物疗法 乙酰半胱氨酸/药理学 胰蛋白酶抑制剂/药理学 

分 类 号：R563.1[医药卫生—呼吸系统]