Objective To evaluate the effect of simvastatin on inflammatory reaction and blood clotting in patients With acute respiratory distress syndrome( ARDS) and its clinical results. Methods A total of 40 cases of moderate and severe ARDS patients Who Were admitted into the ICU of the Second Affiliated Hospital of Wenzhou Medical University from January 2013 to April 2014 Were enrolled and Were randomly divided into control group(n=20)and experimental group(n=20). Patients of the tWo groups Were given mechanical ventilation,etiological treatment and rational anti-infective therapy. The experimental group Was also treated With simvastatin tablets With 40 mg/d for 28 d. Before the intervention and on day 14 and day 28 of the intervention,a series of indicators Were monitored,including CRP,FIB,PLG,vWF,ALT,AST,CK - MB,TC,TG, LDL,HDL,Cr,PaO2/FiO2 and SOFA score. The mechanical ventilation time,length of ICU stay,length of hospital stay, 28-day mortality and in-hospital mortality Were also recorded. Results The tWo groups Were not significantly different( P>0. 05)in gender,age,the state of ARDS,the inspection rate of diabetes mellitus and hypertension. Interaction effect(P <0. 05) existed betWeen the tWo groups in CRP,FIB,vWF,TC,LDL,HDL and SOFA score;Within the tWo groups,CRP, FIB,vWF,TC,HDL and SOFA score varied significantly ( P <0. 05 ) at different time points. The experimental group Was shorter(P<0. 05)than the control group in mechanical ventilation time,length of ICU stay and length of hospital stay;the tWo groups Were not significantly different( P>0. 05 ) in 28 -day mortality and in-hospital mortality. Conclusion Simvastatin can relieve inflammation reaction induced by ARDS, improve vascular endothelial function and blood clotting, reduce the incidence of organ dysfunction and help to disconnect breathing machine early.%目的：评价辛伐他汀对急性呼吸窘迫综合征（ ARDS）患者炎性反应及凝血功能的影响，并评价其临床效果。方法选取2013年1月—2014年4月在温州医科大学附属第二医院成人ICU入住的中重度ARDS患者40例，采用随机数字表法将其分为对照组和试验组各20例。两组患者均给予机械通气、病因治疗及合理抗感染治疗。试验组在此基础上给予辛伐他汀片，40 mg/d，共28 d。监测治疗前，治疗第14、28天患者C反应蛋白（ CRP）、纤维蛋白原（ FIB）、纤溶酶原活性（ PLG）、假性血友病因子（ vWF）、丙氨酸氨基转移酶（ ALT）、天冬氨酸氨基转移酶（ AST）、肌酸激酶同工酶（ CK-MB）、总胆固醇（ TC）、三酰甘油（ TG）、低密度脂蛋白（ LDL）、高密度脂蛋白（ HDL）及肌酐（ Cr）水平，记录氧合指数（ PaO2/FiO2），评估序贯器官衰竭估计（ SOFA）评分，并观察机械通气时间、入住ICU时间、住院时间、28 d病死率及住院病死率。结果两组患者性别、年龄、ARDS病情及糖尿病、高血压检出率比较，差异均无统计学意义（P>0.05）。CRP、FIB、vWF、TC、LDL、HDL及SOFA评分时间与辛伐他汀处理存在交互作用（P<0.05）；两组组内不同时间点CRP、FIB、vWF、TC、HDL及SOFA评分比较，差异有统计学意义（P<0.05）。试验组机械通气时间、入住ICU时间及住院时间均短于对照组（ P<0.05）；两组28 d病死率及住院病死率比较，差异均无统计学意义（P>0.05）。结论辛伐他汀能够减轻ARDS患者的炎性反应，改善血管内皮功能及凝血功能，降低器官功能障碍的发生，有助于早期撤离呼吸机。
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