Luo M, Hu H, Sun Y, Zhao X, Zeng Z, Liu Y, Wu G
Department of Emergency, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Department of Critical Care Medicine, Yuebei People's Hospital, Shaoguan 512000, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2023 Aug 20;43(8):1259-1267. doi: 10.12122/j.issn.1673-4254.2023.08.01.
To investigate the effect of sivelestat sodium on survival, oxygenation index, and serum markers for infection in critically ill patients with COVID-19-associated acute respiratory distress syndrome (ARDS).
This retrospectively study was performed among the critically ill patients with COVID-19-associated ARDS admitted in the intensive care unit (ICU) at Nanfang Hospital, Southern Medical University. We collected the clinical data of the patients on the first day of ICU admission and on the day of discharge and laboratory tests results of interleukin-6 (IL-6), C-reactive protein (CRP) and procalcitonin (PCT) and oxygenation index on days 1, 3 and 7 following ICU admission. Propensity-score matching was used to match the patients receiving sivelestat sodium to those without the treatment. Cox proportional hazards model and linear regression analysis were used to assess the association of sivelestat sodium treatment with in-hospital mortality and the length of hospital stay.
A total of 199 patients with COVID-19-associated ARDS patients were included for data analysis. After propensity-score matching PSM, 35 patients receiving sivelestat sodium were matched to 70 patients without the treatment. Treatment with of sivelestat sodium was not associated with the reduction of in- hospital mortality (=0.36), prolonged ICU stay (=0.39), hospital stay (=0.68) or improved oxygenation index (P>0.05) of the patients. No significant difference was found in serum CRP or PCT levels between the patients with and without sivelestat sodium treatment, but a significant reduction in IL-6 level was found in sivelestat sodium group (=0.016).
Sivelestat sodium treatment is not correlated with the reduction of mortality or length of hospital stay, but is associated with reduced serum IL-6 level in patients with COVID-19-associated ARDS.
探讨西维来司他钠对新型冠状病毒肺炎（COVID-19）相关急性呼吸窘迫综合征（ARDS）危重症患者生存、氧合指数及感染血清标志物的影响。
本回顾性研究在南方医科大学南方医院重症监护病房（ICU）收治的COVID-19相关ARDS危重症患者中进行。收集患者入住ICU第1天和出院当天的临床资料，以及入住ICU后第1、3和7天的白细胞介素-6（IL-6）、C反应蛋白（CRP）、降钙素原（PCT）实验室检测结果和氧合指数。采用倾向评分匹配法将接受西维来司他钠治疗的患者与未接受治疗的患者进行匹配。采用Cox比例风险模型和线性回归分析评估西维来司他钠治疗与住院死亡率和住院时间的相关性。
共纳入199例COVID-19相关ARDS患者进行数据分析。倾向评分匹配（PSM）后，35例接受西维来司他钠治疗的患者与70例未接受治疗的患者匹配。西维来司他钠治疗与患者住院死亡率降低（=0.36）、ICU住院时间延长（=0.39）、住院时间延长（=0.68）或氧合指数改善（P>0.05）无关。接受西维来司他钠治疗和未接受治疗的患者血清CRP或PCT水平无显著差异，但西维来司他钠组IL-6水平显著降低（=0.016）。
西维来司他钠治疗与COVID-19相关ARDS患者死亡率降低或住院时间缩短无关，但与血清IL-6水平降低有关。
