乌司他丁联合肺泡灌洗对重症肺炎伴急性呼吸窘迫综合征患者肺功能的影响

doi:doi:10.3969/j.issn.1002-1949.08.010

Chinese Journal of Critical Care Medicine

2019, Vol. 39

Issue (8): 758-762 DOI: doi:10.3969/j.issn.1002-1949.08.010

Effects of ulinastatin combined with alveolar lavage on pulmonary function in patients with severe pneumonia and acute respiratory distress

Xie Guang-rong, Luo Jia-hua, Wang Quan-gen, Mu Qiong

Intensive Care Unit, Ji′an Central People′s Hospital, Ji′an 343000, China

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Abstract Objective To investigate the effect of ulinastatin combined with alveolar lavage on the expression of alveolar surfactant protein D, inflammatory factor and intercellular junction protein in patients with severe pneumonia and acute respiratory distress. Methods From June 2015 to June 2017, 68 patients with severe pneumonia with acute respiratory distress were selected and divided into control group and observation group. All patients were given routine treatment. The control group was treated with alveolar lavage and the observation group with ulinastatin combined with alveolar lavage. Indexes of blood gas analysis (PaO2, PaCO2, MAP), inflammatory factor (TNF-α, TGF-β, IL-6, IL-10, CRP) and alveolar surfactant protein (SP-A, SP-B, SP-C, SP-D) were compared between two groups before and after treatment, and the level of intercellular connexin (ZO-1 and Occludin) was also compared between two groups before and after treatment. Results On the 3rd day and 7th day after treatment, the PaO2, PaO2/FiO2, pH value of the observation group were significantly higher than those of the control group(3 d：t=5.20, 2.52, 2.53；7 d：t=3.72, 4.33, 2.67;P<0.05). PaCO2 was significantly lower than that in control group(3 d：t=3.59；7 d：t=3.97; P<0.05). On the 3rd day and 7th day after treatment, the levels of TNF-α, IL-6, IL-10 and CRP in the observation group were significantly lower than those in the control group (3 d：t=6.11,6.57,6.41,5.57；7 d：t=11.00,7.42,7.37,15.22). The level of TGF-β was significantly higher than that of the control group (3 d：t=2.27；7 d：t=2.21;P <0.05). On the 3rd day after treatment, the levels of SP-A, SP-B, SP-C and SP-D in the observation group were significantly lower than those in the control group(3 d：t=2.21,4.87,4.46,3.78；7 d：t=5.56,7.62,1.80,3.60;P<0.05). On the 3rd day and 7th day after treatment, the level of ZO-1, Occludin in the observation group was significantly higher than that in the control group(3 d：t=5.89,5.35；7 d：t=7.04,3.88), and the difference was statistically significant ( P <0.05). Conclusion Ulinastatin combined with alveolar lavage can effectively improve the level of inflammatory response, increase the level of ZO-1 and blocking protein, decrease alveolar surfactant protein, and improve the pulmonary function in severe pneumonia patients with acute respiratory distress.

Key words： Severe pneumonia Ulinastatin Alveolar lavage Alveolar surfactant protein D Intercellular junction protein

Corresponding Authors: Mu Qiong, E-mail: 591238166@qq.com

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Xie Guang-rong,Luo Jia-hua,Wang Quan-gen, et al. Effects of ulinastatin combined with alveolar lavage on pulmonary function in patients with severe pneumonia and acute respiratory distress [J]. Chinese Journal of Critical Care Medicine, 2019, 39(8): 758-762.

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http://www.cnemergency.org.cn/EN/doi:10.3969/j.issn.1002-1949.08.010 OR http://www.cnemergency.org.cn/EN/Y2019/V39/I8/758

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