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目的探讨乌司他丁(Ulinastatin,UTI)联合连续性血液净化(continuous blood purification,CBP)治疗急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)的有效性。方法选择自2014年2月—2015年12月在杭州市第三人民医院治疗的ARDS患者96例,按照随机数字法分为观察组和对照组各48例,对照组在常规治疗的基础上加用CBP治疗,而观察组在对照组基础上给予UTI治疗。治疗前后检测2组血pH、动脉血样分压(PaO_2)、动脉二氧化碳分压(PaCO_2)、白介素-6(IL-6)和TNF-α水平以及APACHEⅡ评分、机械通气时间和住院时间等指标。结果治疗后,观察组PaO_2、PaCO_2明显高于对照组(P<0.05);观察组IL-6和TNF-α分别为(41.2±3.8)pg/ml、(54.6±5.2)pg/ml,对照组为(47.5±6.4)pg/ml、(76.8±8.4)pg/ml,观察组IL-6和TNF-α水平均明显低于对照组(P<0.05);观察组APACHEⅡ评分、机械通气时间和住院时间明显低于对照组(P<0.05)。结论 UTI联合CBP治疗能显著改善ARDS患者的血气指标,改善临床检测指标。
Objective To investigate the efficacy of Ulinastatin (UTI) combined with continuous blood purification (CBP) in the treatment of acute respiratory distress syndrome (ARDS). Methods A total of 96 patients with ARDS who were treated in Hangzhou Third People’s Hospital from February 2014 to December 2015 were randomly divided into observation group (48 cases) and control group (48 cases). The control group was treated with conventional therapy Treatment with CBP, while the observation group was given UTI on the basis of the control group. Blood pH, arterial blood pressure (PaO_2), arterial carbon dioxide (PaCO_2), interleukin-6 (IL-6) and TNF-α levels, APACHEⅡscore, mechanical ventilation time and hospital stay were measured before and after treatment. Results After treatment, the PaO_2 and PaCO_2 in the observation group were significantly higher than those in the control group (P <0.05). The levels of IL-6 and TNF-α in the observation group were (41.2 ± 3.8) pg / ml and (54.6 ± 5.2) (47.5 ± 6.4) pg / ml and (76.8 ± 8.4) pg / ml respectively. The levels of IL-6 and TNF-α in the observation group were significantly lower than those in the control group (P <0.05). The APACHEⅡscore of the observation group and the duration of the mechanical ventilation And hospitalization time was significantly lower than the control group (P <0.05). Conclusion UTI combined with CBP can significantly improve the blood gas index of patients with ARDS and improve the clinical detection indexes.