乌司他丁可降低重症肺炎患者的血清炎性因子水平并改善肺功能
|
摘要
为探讨乌司他丁对重症肺炎血清炎性指标、肺功能的影响,为临床应用提供有利的支持,本研究选取2015年1月至2017年6月期间在我院治疗的重症肺炎患者150例作为本次研究的对象,其中接受常规治疗联合乌司他丁治疗的患者83例(乌司他丁组),只接受常规治疗的患者67例(对照组)。比较两组患者治疗前后血清抗炎介质及促炎介质水平,并比较治疗前后的肺功能相关指标、肺表面活性蛋白水平,分析乌司他丁对重症肺炎血清炎性指标、肺功能改善情况。结果表明,治疗前两组患者的血清抗炎及促炎介质指标,差异无统计学意义(p>0.05),而治疗7 d后,乌司他丁组均明显低于对照组,且乌司他丁组肺功能相关指标明显优于对照组,肺表面活性蛋白水平明显低于对照组,差异具有统计学意义(p<0.05);本研究表明,乌司他丁可降低重症肺炎患者的血清炎性因子水平,改善肺功能,具有一定的临床推广价值。
In order to investigate the effect of ulinastatin on the serum inflammatory index and lung function of severe pneumonia, and provide favorable support for clinical application, in this research, one hundred and fifty patients with severe pneumonia who were treated in our hospital from January 2015 to June 2017 were selected as subjects. Among them, 83 patients received conventional treatment combined with ulinastatin treatment(ulinastatin group), and 67 patients only received conventional treatment(control group). The levels of serum anti-inflammatory and pro-inflammatory mediators before and after treatment were compared between the two groups. The lung function related indexes, the levels of pulmonary surfactant protein before and after treatment were compared. The serum inflammatory indexes and the improvement of pulmonary function of severe pneumonia by ulinastatin treatment were analyzed. The results showed that there was no significant difference in serum anti-inflammatory and pro-inflammatory mediators between the two groups before treatment(p>0.05), while 7 d after treatment the ulinastatin group was significantly lower than the control group(p<0.05), the pulmonary function related indexes in ulinastatin group were significantly better than those in the control group, and the level of pulmonary surfactant protein was significantly lower than that in the control group, the difference was statistically significant(p<0.05).This study indicated that ulinastatin could reduce the level of serum inflammatory cytokines and improve the pulmonary function in patients with severe pneumonia, which might have certain clinical popularization value.
In order to investigate the effect of ulinastatin on the serum inflammatory index and lung function of severe pneumonia, and provide favorable support for clinical application, in this research, one hundred and fifty patients with severe pneumonia who were treated in our hospital from January 2015 to June 2017 were selected as subjects. Among them, 83 patients received conventional treatment combined with ulinastatin treatment(ulinastatin group), and 67 patients only received conventional treatment(control group). The levels of serum anti-inflammatory and pro-inflammatory mediators before and after treatment were compared between the two groups. The lung function related indexes, the levels of pulmonary surfactant protein before and after treatment were compared. The serum inflammatory indexes and the improvement of pulmonary function of severe pneumonia by ulinastatin treatment were analyzed. The results showed that there was no significant difference in serum anti-inflammatory and pro-inflammatory mediators between the two groups before treatment(p>0.05), while 7 d after treatment the ulinastatin group was significantly lower than the control group(p<0.05), the pulmonary function related indexes in ulinastatin group were significantly better than those in the control group, and the level of pulmonary surfactant protein was significantly lower than that in the control group, the difference was statistically significant(p<0.05).This study indicated that ulinastatin could reduce the level of serum inflammatory cytokines and improve the pulmonary function in patients with severe pneumonia, which might have certain clinical popularization value.
引文
Gan B.,Huang Y.Q.,and Luo H.W.,2016,Study on the effect of ulinastatin on serum inflammatory factors in patients with severe pneumonia,Zhongguo Yiyao Daokan(Chinese Journal of Medicinal Guide),18(12):1245-1246(甘斌,黄业清,罗红伟,2016,乌司他丁对重症肺炎患者血清炎症因子影响研究,中国医药导刊,18(12):1245-1246)
Ha L.X.,2015,Effect of ulinastatin on immune and inflammatory factors of severe pneumonia,Linchuang Feike Zazhi(Journal of Clinical Pulmonary Medicine),5(12):2253-2255(哈立新,2015,乌司他丁对重症肺炎免疫及炎症因子影响观察,临床肺科杂志,5(12):2253-2255)
Hong X.H.,2015,Research about the influence of ulinastatin for the serum inflammatory markers and pulmonary surfactant protein of patients with severe pneumonia,Hainan Yixueyuan Xuebao(Journal of Hainan Medical University),21(3):335-337(洪旭华,2015,乌司他丁对重症肺炎患者血清炎性指标及肺表面活性蛋白的影响,海南医学院学报,21(3):335-337)
Kesinger M.R.,Kumar R.G.,Wagner A.K.,Peitzman A.P.,Billiar T.R.,and Sperry J.L.,2015,Hospital-acquired pneumonia is an independent predictor of poor global outcome in severe traumatic brain injury up to 5 years after discharge,Journal of Trauma&Acute Care Surgery,78(2):396-402
Li S.Q.,Sun X.L.,Wang Z.Y.,Han B.X.,Li J.L.,Shen L.,and Wu C.L.,2016,Effect of ulinastatin on TNF-α,IL-6,IL-8and IL-10 in children with serious pneumonia,Zhongguo Jijiu Yixue(Chinese Journal of Critical Care Medicine),36(10):940-942(李树青,孙雪丽,王执勇,韩炳鑫,李锦亮,沈玲,吴春莲,2016,乌司他丁对重症肺炎患儿血清TNF-α,IL-6,IL-8,IL-10水平的影响,中国急救医学,36(10):940-942)
Li X.R.,Li Z.J.,Wang D.Q.,and Shen Q.,2015,Comparative study to the practice of APACHEⅡscore,APACHEⅢscore and pneumonia severity index in the elderly patients with severe pneumonia,Zhongguo Jijiu Yixue(Chinese Journal of Critical Care Medicine),35(11):1013-1016(李晓如,李志军,王东强,沈青,2015,APACHEⅡAPACHEⅢ评分及PSI评分评估老年重症肺炎预后的对比研究,中国急救医学,35(11):1013-1016)
Liu C.,Wang L.,and Jin J.J.,2016,Clinical trial of ulinastatin injection in the treatment of acute severe pneumonia,Zhongguo Linchuang Yaolixue Zazhi(The Chinese Journal of Clinical Pharmacology),32(21):1927-1929(刘畅,王璐,金晶晶,2016,乌司他丁注射液治疗急性重症肺炎的临床研究,中国临床药理学杂志,32(21):1927-1929)
Peng J.,An N.,and Ma J.Q.,2017,Effect of ulinastatin combined with anti-infective therapy on systemic inflammatory response and oxidative stress response in patients with acute severe pneumonia,Hainan Yixueyuan Xuebao(Journal of Hainan Medical University),23(16):2180-2183(彭洁,安娜,马骏麒,2017,乌司他丁联合抗感染治疗对急性重症肺炎患者全身炎症、氧化应激反应的影响,海南医学院学报,23(16):2180-2183)
Tamayose M.,Fujita J.,Parrott G.,Miyagi K.,Maeshiro T.,Hirata T.,Higa F.,Tateyama M.Watanabe A.,Aoki N.,Niki Y.,Kadota J.,Yanagihara K.,Kaku M.,Hori S.,and Kohno S.,2015,Correlations between extent of X-ray infiltration and levels of serum C-reactive protein in adult non-severe community-acquired pneumonia,Journal of Infection&Chemotherapy,21(6):456-463
Wang L.,Kang R.,Xie J.L.,and Xue N.N.,2016,2015,Influence of ulinastatin on pulmonary surfactant protein,anti-inflammatory and pro-inflammatory mediators of patients with severe pneumonia,Hainan Yixueyuan Xuebao(Journal of Hainan Medical University),22(7):646-648(王莉,康睿,谢加利,薛亚妮,2016,乌司他丁对重症肺炎患者肺表面活性蛋白及抗炎、促炎介质的影响,中国生化药物杂志,22(7):646-648)
Wang S.Y.,and Liu L.,2016,Effect of ulinastatin on respiratory function and inflammatory stress of patients with severe pneumonia,Shiyong Linchuang Yixue Zazhi(Journal of Clinical Medicine in Practice),20(7):34-37(王书英,刘磊,2016,乌司他丁对重症肺炎患者呼吸功能及炎性应激状态的影响,实用临床医药杂志,20(7):34-37)
Yang J.Q.,Kong X.L.,and Yang F.H.,2015,Efficacy of ulinastatin in the treatment of adult patients with severe pneumonia and its influence on inflam-matory factors and cellular immune function,Linchuang Feike Zazhi(Journal of Clinical P ulmonary Medicine),5(11):2076-2079(杨家清,孔祥林,杨福海,2015,乌司他丁佐治成人重症肺炎并对炎性因子与细胞免疫功能的影响,临床肺科杂志,5(11):2076-2079)
Ha L.X.,2015,Effect of ulinastatin on immune and inflammatory factors of severe pneumonia,Linchuang Feike Zazhi(Journal of Clinical Pulmonary Medicine),5(12):2253-2255(哈立新,2015,乌司他丁对重症肺炎免疫及炎症因子影响观察,临床肺科杂志,5(12):2253-2255)
Hong X.H.,2015,Research about the influence of ulinastatin for the serum inflammatory markers and pulmonary surfactant protein of patients with severe pneumonia,Hainan Yixueyuan Xuebao(Journal of Hainan Medical University),21(3):335-337(洪旭华,2015,乌司他丁对重症肺炎患者血清炎性指标及肺表面活性蛋白的影响,海南医学院学报,21(3):335-337)
Kesinger M.R.,Kumar R.G.,Wagner A.K.,Peitzman A.P.,Billiar T.R.,and Sperry J.L.,2015,Hospital-acquired pneumonia is an independent predictor of poor global outcome in severe traumatic brain injury up to 5 years after discharge,Journal of Trauma&Acute Care Surgery,78(2):396-402
Li S.Q.,Sun X.L.,Wang Z.Y.,Han B.X.,Li J.L.,Shen L.,and Wu C.L.,2016,Effect of ulinastatin on TNF-α,IL-6,IL-8and IL-10 in children with serious pneumonia,Zhongguo Jijiu Yixue(Chinese Journal of Critical Care Medicine),36(10):940-942(李树青,孙雪丽,王执勇,韩炳鑫,李锦亮,沈玲,吴春莲,2016,乌司他丁对重症肺炎患儿血清TNF-α,IL-6,IL-8,IL-10水平的影响,中国急救医学,36(10):940-942)
Li X.R.,Li Z.J.,Wang D.Q.,and Shen Q.,2015,Comparative study to the practice of APACHEⅡscore,APACHEⅢscore and pneumonia severity index in the elderly patients with severe pneumonia,Zhongguo Jijiu Yixue(Chinese Journal of Critical Care Medicine),35(11):1013-1016(李晓如,李志军,王东强,沈青,2015,APACHEⅡAPACHEⅢ评分及PSI评分评估老年重症肺炎预后的对比研究,中国急救医学,35(11):1013-1016)
Liu C.,Wang L.,and Jin J.J.,2016,Clinical trial of ulinastatin injection in the treatment of acute severe pneumonia,Zhongguo Linchuang Yaolixue Zazhi(The Chinese Journal of Clinical Pharmacology),32(21):1927-1929(刘畅,王璐,金晶晶,2016,乌司他丁注射液治疗急性重症肺炎的临床研究,中国临床药理学杂志,32(21):1927-1929)
Peng J.,An N.,and Ma J.Q.,2017,Effect of ulinastatin combined with anti-infective therapy on systemic inflammatory response and oxidative stress response in patients with acute severe pneumonia,Hainan Yixueyuan Xuebao(Journal of Hainan Medical University),23(16):2180-2183(彭洁,安娜,马骏麒,2017,乌司他丁联合抗感染治疗对急性重症肺炎患者全身炎症、氧化应激反应的影响,海南医学院学报,23(16):2180-2183)
Tamayose M.,Fujita J.,Parrott G.,Miyagi K.,Maeshiro T.,Hirata T.,Higa F.,Tateyama M.Watanabe A.,Aoki N.,Niki Y.,Kadota J.,Yanagihara K.,Kaku M.,Hori S.,and Kohno S.,2015,Correlations between extent of X-ray infiltration and levels of serum C-reactive protein in adult non-severe community-acquired pneumonia,Journal of Infection&Chemotherapy,21(6):456-463
Wang L.,Kang R.,Xie J.L.,and Xue N.N.,2016,2015,Influence of ulinastatin on pulmonary surfactant protein,anti-inflammatory and pro-inflammatory mediators of patients with severe pneumonia,Hainan Yixueyuan Xuebao(Journal of Hainan Medical University),22(7):646-648(王莉,康睿,谢加利,薛亚妮,2016,乌司他丁对重症肺炎患者肺表面活性蛋白及抗炎、促炎介质的影响,中国生化药物杂志,22(7):646-648)
Wang S.Y.,and Liu L.,2016,Effect of ulinastatin on respiratory function and inflammatory stress of patients with severe pneumonia,Shiyong Linchuang Yixue Zazhi(Journal of Clinical Medicine in Practice),20(7):34-37(王书英,刘磊,2016,乌司他丁对重症肺炎患者呼吸功能及炎性应激状态的影响,实用临床医药杂志,20(7):34-37)
Yang J.Q.,Kong X.L.,and Yang F.H.,2015,Efficacy of ulinastatin in the treatment of adult patients with severe pneumonia and its influence on inflam-matory factors and cellular immune function,Linchuang Feike Zazhi(Journal of Clinical P ulmonary Medicine),5(11):2076-2079(杨家清,孔祥林,杨福海,2015,乌司他丁佐治成人重症肺炎并对炎性因子与细胞免疫功能的影响,临床肺科杂志,5(11):2076-2079)