临床肺科杂志
臨床肺科雜誌
림상폐과잡지
Journal of Clinical Pulmonary Medicine
2015年
11期
2076-2079
,共4页
重症肺炎%乌司他丁注射液%氧合指数%细胞免疫%炎性因子%疗效
重癥肺炎%烏司他丁註射液%氧閤指數%細胞免疫%炎性因子%療效
중증폐염%오사타정주사액%양합지수%세포면역%염성인자%료효
severe pneumonia%ulinastatin injection%oxygenation index%cellular immunity%inflammatory factor%clinical efficacy
目的：观察并探讨乌司他丁注射液( UTI)辅助治疗成人社区获得性重症肺炎( SP)中的效果及对外周血炎性因子与T淋巴细胞亚群的影响。方法将2012年7月~2014年12月间入选的105例SP患者随机分为观察组(55例)和对照组(50例),对照组患者予机械通气、抗感染、抗凝、维持酸碱平衡等常规治疗,观察组通过微量泵加用UTI注射液,每次20万IU,每日2次,连用7 d,治疗7 d后,采集动脉血进行血气分析,采外周静脉血测定炎性因子与T淋巴细胞亚群构成,判定两组临床疗效。结果治疗7d后,观察组氧合指数(297．5±27．4)显著高于对照组(274．7±23．8)(u=4．562 P<0．001)；两组疗效构成差异显著(Z=-1．987 P=0．047),观察组总体有效率(89．1%)与显效率(49．7%)均高于对照组(82．0%、30．0%),显效率差异有统计学意义(χ2=3．977 P=0．046)。观察组治疗7d后外周血TNF-α、IL-6、IL-8水平均显著低于对照组(P<0．05)。观察组治疗7d后CD3+%、CD4+%、CD4+/CD8+数值均明显高于对照组(P<0．05)。观察组、对照组病死率(5．5% vs．10．0%)差异无统计学意义(fisher P=0．474)。观察组呼吸机辅助通气时间(8．7±2．3) d、住院时间(13．2±3．1)d,均显著低于对照组时间(10．1±2．8)d、(16．0±3．9)d,差异均有统计学意义(u=2．703 P=0．008；u=3．938 P<0．001)。结论 SP患者早期应用UTI注射液能显著下调体内炎性反应水平,纠正细胞免疫功能紊乱,能进一步提高临床疗效,有助于降低病死率。
目的：觀察併探討烏司他丁註射液( UTI)輔助治療成人社區穫得性重癥肺炎( SP)中的效果及對外週血炎性因子與T淋巴細胞亞群的影響。方法將2012年7月~2014年12月間入選的105例SP患者隨機分為觀察組(55例)和對照組(50例),對照組患者予機械通氣、抗感染、抗凝、維持痠堿平衡等常規治療,觀察組通過微量泵加用UTI註射液,每次20萬IU,每日2次,連用7 d,治療7 d後,採集動脈血進行血氣分析,採外週靜脈血測定炎性因子與T淋巴細胞亞群構成,判定兩組臨床療效。結果治療7d後,觀察組氧閤指數(297．5±27．4)顯著高于對照組(274．7±23．8)(u=4．562 P<0．001)；兩組療效構成差異顯著(Z=-1．987 P=0．047),觀察組總體有效率(89．1%)與顯效率(49．7%)均高于對照組(82．0%、30．0%),顯效率差異有統計學意義(χ2=3．977 P=0．046)。觀察組治療7d後外週血TNF-α、IL-6、IL-8水平均顯著低于對照組(P<0．05)。觀察組治療7d後CD3+%、CD4+%、CD4+/CD8+數值均明顯高于對照組(P<0．05)。觀察組、對照組病死率(5．5% vs．10．0%)差異無統計學意義(fisher P=0．474)。觀察組呼吸機輔助通氣時間(8．7±2．3) d、住院時間(13．2±3．1)d,均顯著低于對照組時間(10．1±2．8)d、(16．0±3．9)d,差異均有統計學意義(u=2．703 P=0．008；u=3．938 P<0．001)。結論 SP患者早期應用UTI註射液能顯著下調體內炎性反應水平,糾正細胞免疫功能紊亂,能進一步提高臨床療效,有助于降低病死率。
목적：관찰병탐토오사타정주사액( UTI)보조치료성인사구획득성중증폐염( SP)중적효과급대외주혈염성인자여T림파세포아군적영향。방법장2012년7월~2014년12월간입선적105례SP환자수궤분위관찰조(55례)화대조조(50례),대조조환자여궤계통기、항감염、항응、유지산감평형등상규치료,관찰조통과미량빙가용UTI주사액,매차20만IU,매일2차,련용7 d,치료7 d후,채집동맥혈진행혈기분석,채외주정맥혈측정염성인자여T림파세포아군구성,판정량조림상료효。결과치료7d후,관찰조양합지수(297．5±27．4)현저고우대조조(274．7±23．8)(u=4．562 P<0．001)；량조료효구성차이현저(Z=-1．987 P=0．047),관찰조총체유효솔(89．1%)여현효솔(49．7%)균고우대조조(82．0%、30．0%),현효솔차이유통계학의의(χ2=3．977 P=0．046)。관찰조치료7d후외주혈TNF-α、IL-6、IL-8수평균현저저우대조조(P<0．05)。관찰조치료7d후CD3+%、CD4+%、CD4+/CD8+수치균명현고우대조조(P<0．05)。관찰조、대조조병사솔(5．5% vs．10．0%)차이무통계학의의(fisher P=0．474)。관찰조호흡궤보조통기시간(8．7±2．3) d、주원시간(13．2±3．1)d,균현저저우대조조시간(10．1±2．8)d、(16．0±3．9)d,차이균유통계학의의(u=2．703 P=0．008；u=3．938 P<0．001)。결론 SP환자조기응용UTI주사액능현저하조체내염성반응수평,규정세포면역공능문란,능진일보제고림상료효,유조우강저병사솔。
Objective To observe and explore the curative effect of ulinastatin ( UTI) in the treatment of a-dult community-acquired severe pneumonia ( SP) patients and its influence on peripheral blood inflammatory factors and cellular immune function. Methods 105 SP patients from Jul. 2012 to Dec. 2014 were enrolled in the study and randomly divided into the observation group (55 cases) and the control group (50 cases). All patients were given mechanical ventilation, anti-infection, anti-coagulation, maintaining acid-base balance and other conventional treat-ment, and the observation group was added with UTI injection by micro pump, 200,000 IU each time, twice a day for 7d. Their arterial blood gas analysis and peripheral blood inflammatory factors and T lymphocyte subsets were exam-ined and the clinical efficacy was evaluated. Results 7 days after the treatment, the oxygenation index was 297. 5 ± 27. 4 in the observation group, which was significantly higher than that in the control group ( 274. 7 ± 23. 8 ) ( P<0. 001 ) . The total effective rate was 89. 1%) and the remarkable effective rate was 49. 7% in the observation group, which were both higher than those in the control group (82. 0% and 30. 0%) (χ2 =3. 977, P=0. 046). The mor-tality showed no significant difference between the two groups ( 5. 5% vs. 10. 0%) . Conclusion SP patients with early application of UTI injection can significantly decrease inflammatory response, correct disorders of cellular im-mune function, and improve therapeutic efficacy.
