【摘要】 目的探讨急性呼吸窘迫综合征(ARDS)病人血C反应蛋白(CRP)和基质金属蛋白酶2(MMP-2)水平的变化及乌司他丁对其的影响。方法对61例收入ICU内的ARDS病人分为乌司他丁治疗组和对照组,治疗组给予乌司他丁20万单位+生理盐水100ml每天2次静脉注射,其余治疗方案两组均相同,然后对两组病人血CRP和MMP-2水平、呼吸频率、氧合指数(PaO2/FiO2)、PaCO2、APACHEII评分进行测定。结果两组病人治疗前各项值呼吸频率(次/分)、PaCO2(mmHg)、PaO2/FiO2、APACHEII评分、年龄及CRP、MMP-2水平无显著性差异;乌司他丁治疗可显著减少ARDS病人血CRP、MMP-2的表达(P<0.01),显著改善ARDS病人的呼吸情况,改善APACHEII评分(P<0.001)。结论乌司他丁抑制ARDS的CRP、MMPs表达和改善呼吸情况,对ARDS病人有保护作用。更多还原

【Abstract】 Objective To study changes of the blood c-reactive protein and matrix metalloproteinase-2 in patients with acute respiratory dis- tress syndrome after trauma and the effect of ulinastatin on them. Methods 61 patients with acute respiratory distress syndrome after trauma were di- vided into ulinastatin treatment group and control group. Ulinastatin treatment group were treated by using ulinastatin 2.0 ×106u+0.9% NS 100ml, intravenously guttae, twice a day. Two groups were all given general treatment such as ventilation, low dosage corticosteroid and so on. The effect of therapy in both group was assessed with respiratory rate, oxygenation index (PaO/FiO2), PaCO2, severity of illness score (acute physiological and chronic health evaluationⅡ,APACHE Ⅱ),c-reactive protein and matrix metalloproteinase -2 .The levels of blood matrix metalloproteinase-2 were detected with enzyme linked immunosorbent assay (ELISA) method to find their difference. Results There were no significant differences in respira- tory rate, oxygenation index (PaO/FiO2), PaCO2, APACHE Ⅱ,the level of matrix metalloproteinase -2, c-reactive protein and age between both group group treatment and control group at first. Ulinastatin treatment could decrease the level of c-reactive protein and matrix metalloproteinase-2 in patients with ARDS (P<0.01), ulinastatin could improve patients’respiration, severity of illness score (P<0.001,all).Conclusion Ulinastatin in- hibit the expressl of matrix metalloproteinases, inflammatory response and improve respiratory function. So ulinastatin has a protective effect on pa- tients with ARDS after trauma.更多还原