【摘要】 目的:研究乌司他丁治疗重症卒中相关性肺炎的疗效及其对患者血清炎症因子的影响。方法:选择2015年1月～2017年6月我院神经内科收治的重症卒中相关性肺炎患者96例,将其随机分为三组。对照组采用机械通气、抗感染、化痰、营养支持和补液等常规治疗,观察组A(低剂量组)在常规治疗基础上给予0.3万U/Kg体重静脉注射Q8h,观察组B(高剂量组)在常规治疗基础上给予给予1.2万U/kg体重静脉注射Q8h,两组均从入院时开始,连续注射7天。分别比较各组的住院时间、咳嗽减轻时间、体温复常时间、啰音消失时间,治疗前后血清白介素-6、肿瘤坏死因子-α以及高迁移率族蛋白-B1(HMGB1)水平的变化。结果:观察组A和B的有效率分别为91.67%和95.84%,均明显高于对照组的70.83%(P<0.05);观察组A和B的住院时间、咳嗽减轻时间、体温复常时间、啰音消失时间均明显短于对照组(P<0.05),且观察组B以上指标均明显短于观察组A(P<0.05)。治疗后,所有患者的血清白介素-6、肿瘤坏死因子-α以及HMGB1水平均较治疗前明显降低(P<0.05),且观察组以上指标明显低于对照组(P<0.05),且观察组B以上指标均明显低于观察组A(P<0.05)。结论:乌司他丁可加快改善卒中相关性肺炎患者的临床症状,可能与降低患者血清炎症因子IL-6、TNF-a和HMGB-1水平有关。更多还原

【Abstract】 Objective: To investigate the clinical efficacy of ulinastatin in the treatment of severe stroke associated pneumonia and its effect on serum inflammatory factors. Methods: 96 cases of patients with severe stroke associated pneumonia in our hospital from January 2015 to June 2017 were selected and randomlydivided into three groups. The control group was treated with mechanical ventilation,anti infection, expectorant, nutritional support, fluid replacement and other conventional treatment. The observation group A(low-dose group) was given intravenous injection of ulinastatin(0.3 million U/Kg, 8 h) on the basis of routine treatment. The observation group B(high-dose group) was given intravenous injection of ulinastatin(1.2 million U/Kg, 8 h) on the basis of routine treatment. Both groups were treated continuously for 7 days after admission. The hospitalization time, relief time of cough, recovery time of body temperature,rales disappearance time, changes of the serum interleukin-6, tumor necrosis factor-alpha and high mobility group box-1(HMGB1) levels before and after treatment were compared among three groups. Results: After treatment, the effective rate of observation group A and B were 91.67 % and 95.84%, which were significantly higher than that of the control group 70.83 %(P<0.05). The hospitalization time, relief time of cough, recovery time of body temperature, rales disappearance time of observation group A and B were significantly shorter than those in the control group(P<0.05). The levels of interleukin-6, tumor necrosis factor alpha and interleukin-23 in the observation A and B groups were significantly lower than those in the control group after the treatment(P<0.05). The levels of interleukin-6, tumor necrosis factor alpha and interleukin-23 in the observation group B were significantly lower than those in the observation A after the treatment(P<0.05). Conclusions: Ulinastatin can accelerate the recovery of patients with stroke-associated pneumonia, which may be related to the decrease of serum inflammatory cytokines IL-6, TNF-α and HMGB-1.更多还原