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乌司他丁联合血必净对重症肺炎患者心肌损伤的保护作用。

The protective effect of ulinastatin combined with Xuebijing on myocardial injuries in patients with severe pneumonia.

作者信息

Wang Sha, Dong Yiming, Wang Jingfeng, Leng Lihong, Song Xianfang, Huang Wanyang

机构信息

Department of Emergency, The Fourth Hospital of Shijiazhuang, Shijiazhuang Obstetrics and Gynecology Hospital Shijiazhuang, Hebei Province, China.

Department of Respiratory Intensive Care Unit II, Weifang People's Hospital Weifang, Shandong Province, China.

出版信息

Am J Transl Res. 2021 Oct 15;13(10):11745-11751. eCollection 2021.

Abstract

OBJECTIVE

To explore the protective effect of ulinastatin combined with Xuebijing on myocardial injuries in patients with severe pneumonia.

METHODS

The clinical data of 86 patients with severe pneumonia treated in our hospital were analyzed retrospectively. According to the treatment method each patient was administered, they were divided into a control group (43 cases, routine treatment + Xuebijing) and an observation group (43 cases, routine treatment + Xuebijing + ulinastatin). All the patients were treated for 2 weeks. The clinical efficacy, the inflammatory factor levels (TNF-α, C-reactive protein (CRP), and procalcitonin (PCT)), the myocardial index levels (creatine kinase-myocardial band (CK-MB), lactic dehydrogenase (LDH), α-hydroxybutyrate dehydrogenase (α-HBDE), N-terminal pro-brain natriuretic peptide (NT-proBNP), and cardiac troponin I (cTn I)), the blood gas index levels (arterial partial pressure of oxygen (PaO), oxygen saturation (SaO), and oxygenation index (OI)), the coagulation functions (prothrombin time (PT), activated partial thromboplastin time (APTT), and fibrinogen (FIB)) and the acute physiology and chronic health evaluation (APACHE-II) scores were compared between the two groups.

RESULTS

After the treatment, the total effective rate in the observation group was higher than it was in the control group (P<0.05). After the treatment, the serum TNF-α, CRP, PCT, CK-MB, LDH, α-HBDE, NT-proBNP, and cTnI levels and the APACHE-II scores were decreased in the two groups, and they were even lower in the observation group (all P<0.05). The PaO, SaO, and OI levels were increased in the two groups, and they were higher in the observation group (all P<0.05). Compared with before the treatment, the patients' PT and APTT levels in both groups were prolonged after the treatment, and the observation group was longer than the control group. The plasma FIB levels were decreased in both groups, and they were lower in the observation group than in the control group (P<0.05).

CONCLUSION

Ulinastatin combined with Xuebijing can significantly alleviate pulmonary inflammation, improve the blood gas, and protect the damaged myocardia in patients with severe pneumonia.

摘要

目的

探讨乌司他丁联合血必净对重症肺炎患者心肌损伤的保护作用。

方法

回顾性分析我院收治的86例重症肺炎患者的临床资料。根据每位患者接受的治疗方法,将其分为对照组(43例,常规治疗+血必净)和观察组(43例,常规治疗+血必净+乌司他丁)。所有患者均治疗2周。比较两组的临床疗效、炎症因子水平(肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)和降钙素原(PCT))、心肌指标水平(肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBDE)、N末端脑钠肽前体(NT-proBNP)和心肌肌钙蛋白I(cTn I))、血气指标水平(动脉血氧分压(PaO)、血氧饱和度(SaO)和氧合指数(OI))、凝血功能(凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)和纤维蛋白原(FIB))以及急性生理与慢性健康状况评分系统(APACHE-II)评分。

结果

治疗后,观察组总有效率高于对照组(P<0.05)。治疗后,两组血清TNF-α、CRP、PCT、CK-MB、LDH、α-HBDE、NT-proBNP和cTnI水平及APACHE-II评分均降低,且观察组更低(均P<0.05)。两组PaO、SaO和OI水平均升高,且观察组更高(均P<0.05)。与治疗前比较,两组患者治疗后PT和APTT水平均延长,且观察组长于对照组。两组血浆FIB水平均降低,且观察组低于对照组(P<0.05)。

结论

乌司他丁联合血必净可显著减轻重症肺炎患者的肺部炎症,改善血气,保护受损心肌。

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