Influence of ulinastatin on inflammatory response and cellular immune function in patients with acute respiratory distress syndrome / 实用医学杂志

ABSTRACT

Objective To observe the influence of ulinastatin (UTI) on curative effect,inflammatory response and cellular immune function in patients with acute respiratory distress syndrome (ARDS).Methods 96 patients with ARDS were randomly divided into two groupsthe control group (48 cases) were treated with conventional treatment,and the UTI group (48 cases) were added with UTI injection based on the control group treatment.The changes of oxygenation index,vital signs,inflammatory factors and T lymphocyte subsets of patients in the two groups were compared before treatment and after treatment in 7 days,recorded the duration of mechanical ventilation time,ICU treatment time and mortality rate in ICU in the two groups.Results After treatment in 7 days,the vital signs (RF,HR,MAP),inflammatory factors (TNF-α,IL-6,IL-8,PCT,CRP,WBC),liver function (AST,ALT),renal function (BUN,Cr) and APACHE Ⅱ score,MODS score of UTI patients in the UTI group were lower than those in the control group (P ＜ 0.05 or P ＜ 0.01).Oxygenation index (PaO2/FiO2) and cellular immunity (CD4+,CD4+/CD8+) in the UTI group were higher than those in the control group (P ＜ 0.01).Mechanical ventilation time,ICU treatment time in the UTI group were shorter than those in the control group (all P ＜ 0.05),the mortality rate of ICU in the UTI group was lower than that in the control group (P ＜ 0.05).There was no significant difference in the incidence of adverse reactions between the two groups (P ＞ 0.05).Conclusions UTI can more effectively improve oxygen metabolism,vital signs for ARDS,liver and kidney function,reduce the APACHE Ⅱ score and MODS score,shorten the mechanical ventilation time and ICU treatment time,reduce the mortality rate of ICU.Its mechanism may relate to clearance of inflammatory factors and regulate cellular immune function of UTI.