| 赵戊辰,喻国灿,俞文峰,高丹,叶波,陈良亮.西维来司他钠在结核性大咯血合并急性呼吸窘迫综合症患者中的临床应用研究[J].浙江中西医结合杂志,2026,36(2): |
| 西维来司他钠在结核性大咯血合并急性呼吸窘迫综合症患者中的临床应用研究 |
| Clinical Application Study of Sivelestat Sodium in Patients with Tuberculous Massive Hemoptysis Complicated with Acute Respiratory Distress Syndrome (ARDS) |
| 投稿时间：2025-09-01 修订日期：2025-12-01 |
| DOI： |
| 中文关键词: 结核性大咯血 西维来司他钠 急性呼吸窘迫综合征 炎症因子 |
| 英文关键词:Tuberculous massive hemoptysis Sivelestat sodium Acute respiratory distress syndrome (ARDS) Inflammatory factors |
| 基金项目:杭州市生物医药和健康产业发展扶持专项项目(No.2022 WJC213) |
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| 中文摘要: |
| 【】目的:探讨西维来司他钠在结核性大咯血合并急性呼吸窘迫综合症(ARDS)患者中的作用。方法:选取2022年12月至2024年11间我院收治的结核性大咯血合并ARDS患者共81例,随机分为对照组42例和试验组39例,试验组在常规治疗的基础上加入西维来司他钠注射液进行治疗。治疗结束后对比两组患者的临床疗效(ICU入住时间、气管插管机械通气时间、高流量通气时间及住院费用)、不良反应、30天死亡率、症状改善情况、炎症因子(IL-6、WBC、中性粒细胞、CRP) 等。结果:经治疗1周后,两组患者的氧合指数、IL-6、WBC、中性粒细胞、CRP等均较前改善,但组间比较显示:试验组经治疗后氧合指数改善更好,中性粒细胞弹性蛋白酶(NE)更低,大咯血患者行血管介入等积极治疗后患者的预后更好,死亡率更低,差异均具有统计学意义(P＜0.05)。结论:西维来司他钠联合血管介入能有效改善结核性大咯血患者的氧合情况,促进肺功能恢复,效果显著。 |
| 英文摘要: |
| 【】Objective: To explore the effect of sivelestat sodium in patients with tuberculous massive hemoptysis complicated with acute respiratory distress syndrome (ARDS). Methods: A total of 81 patients with tuberculous massive hemoptysis complicated with ARDS admitted to our hospital from December 2022 to November 2024 were selected and randomly divided into a control group (42 cases) and an experimental group (39 cases). On the basis of conventional treatment, the experimental group was additionally given sivelestat sodium injection. After the end of treatment, the clinical efficacy (ICU stay time, tracheal intubation mechanical ventilation time, high-flow ventilation time, and hospitalization cost), adverse reactions, 30-day mortality, symptom improvement, and inflammatory factors (IL-6, WBC, neutrophils, CRP) were compared between the two groups. Results: After 1 week of treatment, the oxygenation index, IL-6, WBC, neutrophils, and CRP of patients in both groups were improved compared with those before treatment. However, inter-group comparison showed that: the experimental group had a better improvement in oxygenation index, a lower level of neutrophil elastase (NE) after treatment; patients with massive hemoptysis who received active treatment such as interventional therapy had a better prognosis and a lower mortality rate. All the above differences were statistically significant (P < 0.05). Conclusion: Sivelestat sodium combined with vascular intervention can effectively improve the oxygenation status of patients with tuberculous massive hemoptysis and promote the recovery of lung function, with a significant effect.? |
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