西维来司他钠联合美罗培南治疗儿童脓毒症合并ARDS的疗效及对Nrf2/HO⁃1信号通路的影响  

Efficacy of silvelestat sodium combined with meropenem in the treatment of ARDS in children with sepsis and its influence on Nrf2/HO⁃1 signaling pathway

作　　者：叶文华 曹觅 杨在东[1] YE Wenhua;CAO Mi;YANG Zaidong(Department of Critical Care Medicine,Foshan Maternal and Child Health Hospital,Foshan,Guangdong,China,528000)

机构地区：[1]广东省佛山市妇幼保健院重症医学科,广东佛山528000

出　　处：《分子诊断与治疗杂志》2025年第1期34-37,共4页Journal of Molecular Diagnostics and Therapy

基　　金：广东省佛山市科技局立项(2220001004011)。

摘　　要：目的观察西维来司他钠(SIV)联合美罗培南治疗儿童脓毒症合并急性呼吸窘迫综合征(ARDS)的疗效及其对核因子E2相关因子(Nrf2)/红素加氧酶⁃1(HO⁃1)信号通路的影响。方法选取2021年1月至2024年1月间入住佛山市妇幼保健院儿童重症监护病房(PICU)的脓毒症合并ARDS儿童患者共100例,根据随机数字表法分为SIV组(50例,常规+SIV治疗)和联合组(50例,常规+SIV+美罗培南治疗)。记录治疗期间两组死亡率及恢复情况,对比治疗前后的临床评分、呼吸功能及血液相关指标。结果治疗后联合组的儿童病例危重(PICS)评分和氧合指数均高于SIV组,全身炎症反应综合征(SIRS)评分和快速序贯器官衰竭(qSOFA)评分均低于SIV组,差异有统计学意义(P<0.05);治疗后联合组的Nrf2和HO⁃1水平均高于SIV组,白介素⁃6(IL⁃6)水平均低于SIV组,差异有统计学意义(P<0.05);两组7天内死亡率差异无统计学意义(P>0.05),联合组的呼吸机治疗时长和PICU住院天数均低于SIV组,差异有统计学意义(P<0.05);两组不良反应发生率差异无统计学意义(P>0.05)。结论SIV联合美罗培南对儿童脓毒症合并ARDS疗效确切,其作用与上调Nrf2/HO⁃1信号通路有关。Objective To observe the efficacy of sivelestat sodium(SIV)combined with merope⁃nem in the treatment of children with sepsis complicated with acute respiratory distress syndrome(ARDS)and its effect on nuclear factor E2⁃related factor(Nrf2)/erythrosine oxygenase⁃1(HO⁃1)signaling pathway.Methods A total of 100 pediatric patients with sepsis and ARDS were admitted to the PICU of Foshan Mater⁃nal and Child Health Hospital from January 2021 to January 2024.They were selected and randomly divided into two groups:the SIV group(50 cases,receiving conventional+SIV treatment)and the combination group(50 cases,receiving conventional+SIV+meropenem treatment).The mortality and recovery both groups were re⁃corded during treatment,and the clinical scores,respiratory function and blood related indexes before and after treatment were compared.Results After treatment,the pediatric critical illness score and oxygenation index of the combined group were higher than those of the SIV group.The systemic inflammatory response syndrome score and quick sequential organ failure rating scale score were lower in the combined group compared to the SIV group(P<0.05).After treatment,the levels of Nrf2 and HO⁃1 in the combination group were higher than those in the SIV group,while the levels of IL⁃6 were lower in the combination group(P<0.05).There was no significant difference in 7⁃day mortality between the two groups(P>0.05).The duration of ventilator treatment and PICU hospitalization days were lower in the combined group compared to the SIV group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(c2=1.223,P>0.05).Conclusion SIV combined with meropenem is effective in the treatment of children with sepsis and ARDS.Its effectiveness is linked to the up⁃regulation of the Nrf2/HO⁃1 signaling pathway.

关 键 词：儿童脓毒症 急性呼吸窘迫综合征 西维来司他钠 美罗培南 核因子E2相关因子/红素加氧酶⁃1信号通路 

分 类 号：R720.597[医药卫生—急诊医学]