海南医科大学学报

目的:探讨乌司他丁对慢性阻塞性肺疾病急性期患者血清炎性因子水平及氧化应激的影响。方法:选择2012年8月~2014年8月期间我院接收并确诊的慢性阻塞性肺疾病急性期患者116例,采用随机数表法将其分为两组,对照组(n=58)采用常规治疗,包括吸氧、抗感染、解痉、平喘、化痰等,观察组(n=58)则在常规治疗的同时加用乌司他丁,于治疗前后检测炎性因子指标白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)以及氧化应激指标超氧化物歧化酶(SOD)、活性氧(ROS)、谷胱甘肽过氧化物酶(GSH-PX)、丙二醛(MDA)。结果:两组患者治疗后血清IL-6、IL-8、TNF-α及CRP水平均较同组治疗前明显降低,且观察组治疗后较对照组治疗后降低更明显(P<0.05);治疗后两组SOD和GSH-PX较同组治疗前明显升高,ROS和MDA较同组治疗前明显降低(P<0.05),且观察组治疗后SOD和GSH-PX显著高于对照组治疗后,ROS和MDA显著低于对照组治疗后(P<0.05)。结论:乌司他丁能够有效抑制慢性阻塞性肺疾病急性期患者的炎性反应和氧自由基,减轻氧化应激引起的组织损伤,值得临床推广应用。

Objective:To investigate the effects of ulinastatin on inflammatory factor and oxidative stress of patients with chronic obstructive pulmonary disease at acute stage.Methods:A total of 116 cases of chronic obstructive pulmonary disease in our hospital were randomly divided into two groups by coin toss method.Patients in control group(n=58)were given with conventional treatment,including oxygen,anti infection,spasmolysis,antiasthmatic,expectorant.Patients in observation group(n=58)were treated with ulinastatin on the basis of the conventional treatment.The levels of inflammatoryfactor index(IL-6)and interleukin-6,interleukin-8(IL-8),tumor necrosis factor alpha(TNF-alpha),C reactive protein(CRP)and the parameters of oxidative stress,superoxide dismutase(SOD),reactive oxygen species(ROS),glutathione peroxidase(GSHPX),malondialdehyde(MDA)before and after treatment were detected.Results:The serum IL-6,IL-8,TNF-alpha and CRP levels after treatment were significantly lower than the same group before treatment,and those in the observation group were significantly decreased than in the control group after treatment(P<0.05).After the treatment,SOD and GSH-PX of two groups significantly increased compared with group before treatment,ROS and MDA significantly decreasedcompared with before treatment(P<0.05).In the observation group after treatment,SOD and GSH-PX were significantly higher than that of the control group after treatment,ROS and MDA were significantly lower than those of the control group after treatment(P<0.05).Conclusions:Ulinastatin can effectively inhibit inflammatory reaction and oxygen free radicals in patients with acute stage of chronic obstructive pulmonary disease,reduce tissue damage induced by oxidative stress.It is worthy of clinical application.