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

Effect of ulinastatin combined with large dose ambroxol on pulmonary function and oxidative stress in patients with severe burn

摘要:

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。

Abstract:

To observe the effect of ulinastatin combined with large dose ambroxol on pulmonary function and oxidative stress in patients with severe burn. Methods 106 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. Results The results of FVC, FEV1, PEF and PEF25 in two groups were compared, a: the FVC, FEV1, PEF, PEF25 levels were difference (F group = 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 (F time = 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 (F interaction = 3.015, 3.472, 3.204 and 3.811,p < 0.05).The results of PaO2, PaCO2, PaO2/FiO2 in two groups were compared, a: the PaO2, PaCO2, PaO2/FiO2 levelswere 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 (F time = 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 of p< 0.05) levels in the two groups were different (F interaction = 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 (F group = 5.356, 6.230, 8.375,11.025,p = 0.000) at different time points; b: all indexes of the two groups were different (F time = 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(F interaction = 4.917, 6.335, 6.274 and 5.923, p= 0.000). Conclusions Ulinastatin combined with large dose ambroxol can improve the pulmonary function and inhibit oxidative stress reaction significantly.