目的 探讨乌司他丁联合东莨菪碱对急性呼吸窘迫综合征 (ARDS) 患者炎性因子、免疫功能的影响, 为临床拟制用药方案提供参考.方法选取98例ARDS患者, 将其按随机数字表法分为常规组49例与治疗组49例.常规组予以常规治疗, 治疗组在其基础上予以乌司他丁联合东莨菪碱治疗.比较2组炎性因子、T淋巴细胞亚群水平变化, 记录2组ICU治疗、机械通气时间及病死率.结果 经1周治疗后, 治疗组患者白细胞介素-6 (IL-6) 、肿瘤坏死因子-α (TNF-α) 、白细胞介素-8 (IL-8) 、C反应蛋白 (CRP) 、降钙素原 (PCT) 以及白细胞计数 (WBC) 水平均明显低于常规组 (P均＜0. 05) , CD4+、CD4+/CD8+均显著高于常规组 (P均＜0. 05) , 而2组治疗前后及2组间CD8+比较差异均无统计学意义 (P均＞ 0. 05) ;治疗组患者ICU治疗及机械通气时间均明显短于常规组 (P均＜0. 05) ;治疗组ICU内病死率比较明显低于常规组 (P均＜0. 05) .2组不良反应均较为轻微且组间比较差异均无统计学意义 (P均＞ 0. 05) .结论 乌司他丁联合东莨胆碱能够有效改善患者的免疫功能, 清除炎性因子, 降低病死率, 缩短治疗时间, 具有应用推广价值.%Objective It is to investigate the effects of ulinastatin combined with scopolamine on inflammatory factors and immune function in patients with acute respiratory distress syndrome (ARDS) , and to provide reference for clinical preparation of drug regimens. Methods Ninety-eight patients with ARDS were enrolled and divided into conventional group (n = 49) and treatment group (n = 49) according to the random number table method. The conventional group was treated with routine therapy, and the treatment group was treated with ulinastatin and scopolamine based on the conventional group.The changes of the levels of inflammatory factors and T lymphocyte subsets were compared between the two groups. The ICU treatment, mechanical ventilation time and mortality of the two groups were recorded. Results After 1 week of treatment, the levels of interleukin-6 (IL-6) , tumor necrosis factor-α (TNF-α) , interleukin-8 (IL-8) , C-reactive protein (CRP) , procalcitonin (PCT) and white blood cell count (WBC) in the treatment group were significantly lower while CD4+and CD4+/CD8+were significantly higher than those in the conventional group (P ＜ 0. 05) , but there was no significant difference in the level of CD8+before and after treatment and between the two groups (P＞ 0. 05). ICU treatment and mechanical ventilation time in the treatment group were significantly shorter than that of the conventional group (P ＜ 0. 05). The mortality in the ICU was significantly lower in the treatment group than that in the conventional group (P ＜ 0. 05). The adverse reactions in both groups were mild and the differences between the groups were not significant (P＞ 0. 05). Conclusion Ulinastatin combined with scutellaria choline can effectively improve the immune function, eliminate inflammatory factors, reduce mortality, shorten treatment time in the patients with ARDS, it is worthy promoting in clinic.
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