2019 年第 5 期 第 14 卷

乌司他丁治疗创伤后急性肺损伤的临床效果分析

Clinical effect of urinastatin on post-traumatic acute lung injury

作者：段小丽张赛涂悦王振国刘洋

英文作者：

单位：300162天津，中国人民武装警察部队特色医学中心呼吸与重症医学科（段小丽），脑科中心（张赛、涂悦、王振国）；200081上海市第四人民医院神经内科（刘洋）

英文单位：

关键词：创伤后急性肺损伤；乌司他丁；Meta分析

英文关键词：

• 摘要：

• 【摘要】目的    评价乌司他丁治疗对创伤后急性肺损伤（ALI）患者呼吸功能及预后的影响。方法    检索中英文数据库有关乌司他丁治疗创伤后ALI的随机对照试验，采用Meta分析，比较乌司他丁组（乌司他丁+常规治疗）和对照组（常规治疗）动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）、PaO2/吸入氧浓度百分比（FiO2）水平和急性呼吸窘迫综合征（ARDS）发生率及病死率。结果    共纳入7个乌司他丁治疗创伤后ALI的随机对照试验研究文献。Meta分析结果显示，乌司他丁组PaO2水平明显高于对照组，差异有统计学意义（均数差=11.05，95%置信区间：4.59～17.50，P＜0.05）；乌司他丁组PaCO2水平与对照组比较，差异无统计学意义（P=0.87）；乌司他丁组PaO2/FiO2水平明显高于对照组，差异有统计学意义（均数差=65.35，95%置信区间：17.52～113.18，P=0.007）；乌司他丁组ARDS发生率和病死率明显低于对照组，差异均有统计学意义（比值比=0.34、0.31，95%置信区间：0.20～0.60、0.15～0.65，均P＜0.05）。结论    乌司他丁能够改善创伤后ALI患者呼吸功能和预后情况。

• 【Abstract】Objective    To evaluate the effect of urinastatin on respiratory function and prognosis in patients with post-traumatic acute lung injury (ALI). Methods    Clinical randomized controlled trials of urinastatin treating post-traumatic ALI were searched in Chinese and English databases. Arterial partial pressure of oxygen（PaO2）, arterial partial pressure of carbon dioxide（PaCO2）, PaO2/inhaled oxygen concentration（FiO2）, incidence of acute respiratory distress syndrome（ARDS） and mortality were analyzed between urinastatin group(treated by urinastatin on the basis of routine therapy) and control group（treated by routine therapy） through meta analysis. Results    Seven literatures were included in meta analysis. Compared with the control group, the urinastatin group showed significant increases in PaO2［mean difference=11.05， 95% confidence interval(CI): 4.59-17.50， P＜0.05］ and PaO2/FiO2(mean difference=65.35， 95%CI: 17.52-113.18， P=0.007). There was no statistical significance of PaCO2 between the control group and urinastatin group(P=0.87). Incidence of ARDS and mortality rate in urinastatin group were significantly lower than those in control group（odds ratio=0.34, 0.31; 95%CI: 0.20-0.60, 0.15-0.65; both P＜0.05）. Conclusion    Urinastatin can improve respiratory function and prognosis of patients with post-traumatic acute lung injury.