乌司他丁联合大剂量氨溴索对重度烧伤患者肺功能及氧化应激的影响

2017-09-12肖宏涛田社民魏莹查新建夏成德

中国现代医学杂志 2017年15期

关键词：氧化应激剂量水平

肖宏涛，田社民，魏莹，查新建，夏成德

（河南省郑州市第一人民医院烧伤科，河南郑州 450000）

乌司他丁联合大剂量氨溴索对重度烧伤患者肺功能及氧化应激的影响

肖宏涛，田社民，魏莹，查新建，夏成德

（河南省郑州市第一人民医院烧伤科，河南郑州 450000）

目的观察乌司他丁联合大剂量氨溴索对重度烧伤患者肺功能及氧化应激的影响。方法将106例重度、特重度烧伤患者随机分为观察组（55例）和对照组（51例）。观察组在常规治疗的基础上给予乌司他丁和大剂量氨溴索（即：210 mg/t，8 h/次，静脉输注），对照组在常规治疗的基础上给予乌司他丁和常规剂量氨溴索（即：30 mg/t，8 h/次，静脉输注）。治疗10 d，观察两组肺功能相关指标[用力肺活量（FVC）、第1秒最大呼气量（FEV1）、最高呼气峰流速（PEF）、25%时瞬时流量（PEF 25%）、动脉血氧分压（PaO2）、二氧化碳分压（PaCO2）、PaO2/吸入氧浓度百分比（FiO2）]及氧化应激指标[丙二醛（MDA）、髓过氧化物酶（MPO）、脂质过氧化物（LPO）、总氧化能力（TAO）]的变化。结果①两组FVC、FEV1、PEF及PEF25%水平差异有统计学意义（P<0.05），观察组与对照组相比各指标水平均比较高，肺功能更好；②两组PaO2、PaCO2及PaO2/FiO2水平差异有统计学意义（P<0.05），观察组与对照组比较各指标水平更优，血气指标水平更好；③两组MDA、MPO、LPO及TAO水平差异有统计学意义（P<0.05），观察组与对照组相比各指标水平更低，氧化应激水平更低。结论乌司他丁联合大剂量氨溴索治疗重度烧伤患者，能改善肺功能、抑制氧化应激反应。

重度烧伤；乌司他丁；氨溴索；肺功能；氧化应激

Abstract:ObjectiveTo observe the effect of ulinastatin combined with large dose ambroxol on pulmonary function and oxidative stress in patients with severe burn.Methods106 cases severe burned patients were randomly divided into the observation group (55 cases)and the control group (51 cases).The observation group was given ulinastatin and large dose ambroxol (Namely:210 mg/t,one time every 8 hour intravenous infusion)based on conventional therapy,and the control group was given ulinastatin and routine dose ambroxol(Namely:30 mg/t,one time every 8 hour intravenous infusion)based on conventional therapy.After 10-days treatment,the differences of pulmonary function indexes(FVC,FEV1,PEF,PEF 25%and PaO2,PaCO2,PaO2/FiO2)and oxidative stress indexes (MDA,MPO,LPO,TAO)were observed between two groups.ResultsThe results of FVC,FEV1,PEF and PEF25 in two groups were compared,a:the FVC,FEV1,PEF,PEF25 levels were difference (Fgroup=3.103,4.224,3.184 and 3.827,P<0.05)at different time points;b:all indexes of the two groups were difference (Ftime=4.430,5.037,4.472 and 4.014,P<0.05).and the observation group were higher than those of the control group,had better lung function.c:the variation tendencies of FVC,FEV1,PEF and PEF25 levels in the two groups were different (Finteraction=3.015,3.472,3.204 and 3.811,P<0.05).The results of PaO2,PaCO2,PaO2/FiO2in two groups were compared,a:the PaO2,PaCO2,PaO2/FiO2levelswere different (Fgroup=6.338,8.03 and 9.238,P<0.05)at different time points;b:all indexes of the two groups were different (Ftime=8.429,7.038,6.256,P=0.000).and the observation group were better than those of the control group,had better blood gas indexes;c:the variation tendencies ofP<0.05)levels in the two groups were different (Finteraction=5.104,5.472 and 4.629,P=0.000).The results of MDA,MPO,LPO,TAO in two groups were compared,a:the MDA,MPO,LPO,TAO levels were different (Fgroup=5.356,6.230,8.375,11.025,P=0.000)at different time points;b:all indexes of the two groups were different(Ftime=8.273,8.429,10.632 and 9.172,P=0.000).and the observation group were lower than those of the control group,had lower oxidative stress;c:The variation tendencies of MDA,MPO,LPO,TAO levels in the two groups were different(Finteraction=4.917,6.335,6.274 and 5.923,P=0.000).ConclusionsUlinastatin combined with large dose ambroxol can improve the pulmonary function and inhibit oxidative stress reaction significantly.

Keywords:severe burn;ulinastatin;ambroxol;pulmonary function;oxidative stress

重度烧伤后极易发生呼吸功能异常[1]，且剧烈的氧化应激反应、炎症反应会严重损伤患者机体，导致其出现病情恶化、甚至死亡的重要原因。因此，更好的保护肺功能、抑制氧化应激反应已被公认是重度烧伤后的重要治疗目的，对改善患者预后效果有益[2]。本研究观察乌司他丁联合大剂量氨溴索对重度烧伤患者肺功能及氧化应激的影响，可为临床应用提供参考。