乌司他丁对卒中相关性肺炎的疗效及血清炎症因子的影响.

Objective: To investigate the clinical efficacy of ulinastatin in the treatment of severe stroke associated pneumonia and its effect on serum inflammatory factors. Methods: 96 cases of patients with severe stroke associated pneumonia in our hospital from January 2015 to June 2017 were selected and randomlydivided into three groups. The control group was treated with mechanical ventilation,anti infection, expectorant, nutritional support, fluid replacement and other conventional treatment. The observation group A(low-dose group) was given intravenous injection of ulinastatin(0.3 million U/Kg, 8 h) on the basis of routine treatment. The observation group B(high-dose group) was given intravenous injection of ulinastatin(1.2 million U/Kg, 8 h) on the basis of routine treatment. Both groups were treated continuously for 7 days after admission. The hospitalization time, relief time of cough, recovery time of body temperature,rales disappearance time, changes of the serum interleukin-6, tumor necrosis factor-alpha and high mobility group box-1(HMGB1) levels before and after treatment were compared among three groups. Results: After treatment, the effective rate of observation group A and B were 91.67 % and 95.84%, which were significantly higher than that of the control group 70.83 %(P<0.05). The hospitalization time, relief time of cough, recovery time of body temperature, rales disappearance time of observation group A and B were significantly shorter than those in the control group(P<0.05). The levels of interleukin-6, tumor necrosis factor alpha and interleukin-23 in the observation A and B groups were significantly lower than those in the control group after the treatment(P<0.05). The levels of interleukin-6, tumor necrosis factor alpha and interleukin-23 in the observation group B were significantly lower than those in the observation A after the treatment(P<0.05). Conclusions: Ulinastatin can accelerate the recovery of patients with stroke-associated pneumonia, which may be related to the decrease of serum inflammatory cytokines IL-6, TNF-α and HMGB-1. [ABSTRACT FROM AUTHOR]