西维来司他钠在新型冠状病毒肺炎相关急性呼吸窘迫综合征中的疗效分析及预后影响
Efficacy Analysis and Prognostic Impact of Sivelestat Sodium in Coronavirus Disease 2019-Related Acute Respiratory Distress Syndrome.
作者信息
Che Xiao, Hu Wei, Zhang Ziying, Wang Lexiao, Xu Zhe, Wang Fusheng
机构信息
Senior Department of Infectious Disease, The Fifth Medical Center of PLA General Hospital, Beijing 100039, China.
出版信息
Pharmaceuticals (Basel). 2024 Mar 12;17(3):368. doi: 10.3390/ph17030368.
PURPOSE
This study aimed to evaluate the efficacy of sivelestat sodium on mortality, oxygenation index, and serum markers in patients with acute respiratory distress syndrome (ARDS) associated with Coronavirus Disease 2019 (COVID-19).
METHODS
A retrospective analysis was conducted on adult inpatients admitted to the Intensive Care Unit (ICU). The study compared clinical characteristics, laboratory indices, and mortality rates between patients treated with and without sivelestat sodium. Cox regression analysis was employed to assess the effect of sivelestat sodium on the risk of death, oxygenation index, and improvement of serum markers in patients with COVID-19-associated ARDS.
RESULTS
A total of 110 patients with COVID-19-associated ARDS were included, with 45 patients in the sivelestat group and 65 patients in the control group. The overall patient mortality rate was 69.1%, with 62.2% in the sivelestat group and 73.8% in the control group. After five days of treatment, the median change from baseline in the oxygenation index was 21 mmHg in the medicated group and -31 mmHg in the control group ( < 0.05). Analysis of the oxygenation index as a clinical endpoint event showed a significantly higher rate of improvement in the sivelestat group compared to the control group (57.8% vs. 38.5%, < 0.05), and the odds of raising the oxygenation index after treatment were 2.05 times higher in the sivelestat group than in the control group (HR = 2.05, 95%CI: 1.02-4.15, < 0.05). Among patients with a baseline oxygenation index < 200 mmHg, patients in the sivelestat group had an 86% lower risk of death compared to the control group (HR = 0.14, 95%CI: 0.02-0.81, < 0.05).
CONCLUSIONS
Sivelestat sodium demonstrated a significant improvement in the oxygenation index of patients with COVID-19-associated ARDS and was found to considerably reduce the risk of death in patients with a baseline oxygenation index of <200 mmHg.
目的
本研究旨在评估西维来司他钠对2019冠状病毒病（COVID-19）相关急性呼吸窘迫综合征（ARDS）患者死亡率、氧合指数和血清标志物的疗效。
方法
对入住重症监护病房（ICU）的成年住院患者进行回顾性分析。该研究比较了接受和未接受西维来司他钠治疗的患者的临床特征、实验室指标和死亡率。采用Cox回归分析评估西维来司他钠对COVID-19相关ARDS患者死亡风险、氧合指数和血清标志物改善的影响。
结果
共纳入110例COVID-19相关ARDS患者，西维来司他组45例，对照组65例。总体患者死亡率为69.1%，西维来司他组为62.2%，对照组为73.8%。治疗5天后，用药组氧合指数较基线的中位数变化为21 mmHg，对照组为-31 mmHg（<0.05）。将氧合指数作为临床终点事件分析显示，西维来司他组的改善率显著高于对照组（57.8%对38.5%，<0.05），治疗后提高氧合指数的几率西维来司他组比对照组高2.05倍（HR = 2.05，95%CI：1.02 - 4.15，<0.05）。在基线氧合指数<200 mmHg的患者中，西维来司他组患者的死亡风险比对照组低86%（HR = 0.14，95%CI：0.02 - 0.81，<0.05）。
结论
西维来司他钠显著改善了COVID-19相关ARDS患者的氧合指数，并发现可显著降低基线氧合指数<200 mmHg患者的死亡风险。
Zotero 插件