不同剂量乌司他丁联合微量推注泵美罗培南对重症肺炎患者的疗效及血管生成素2的影响

摘要 目的：探讨与分析不同剂量乌司他丁联合微量推注泵美罗培南对重症肺炎患者的疗效及血管生成素-2的影响。方法：2019年1月到2022年2月选择在本院诊治的重症肺炎患者78例作为研究对象，将其分为研究组与对照组各39例，两组都给予美罗培南微量推注治疗，研究组与对照组分别给予高剂量与低剂量的乌司他丁治疗，连续应用7 d，观察患者的疗效及血清血管生成素2表达变化情况。结果：研究组的ICU住院时间、退热时间、炎症吸收时间与痰液颜色改变时间较对照组少（P<0.05）。研究组的治疗总有效率较对照组高（P<0.05）。两组治疗后的血清白细胞介素-6（IL-6）、白细胞介素-17（IL-17）含量明显低于治疗前(P<0.05)，研究组治疗后的血清IL-6、IL-17含量也明显低于对照组（P<0.05）。两组治疗后的血清血管生成素-2含量低于治疗前，治疗后研究组血清血管生成素-2含量低于对照组（P<0.05）。结论：高剂量乌司他丁联合微量推注泵美罗培南在重症肺炎患者的应用能抑制血清血管生成素-2的表达，也可抑制血清IL-6、IL-17的表达，从而能提高治疗效果，促进改善患者的临床症状，有利于患者康复。

Efficacy of Different Doses of Ulinastatin Combined with Microbolus Meropenem in Patients with Severe Pneumonia and the Effect of Angiopoietin 2

ABSTRACT Objective: To investigate and analysis the efficacy of different doses of ulinastatin combined with microbolus meropenem in patients with severe pneumonia and the effect of angiopoietin-2. Methods: From January 2019 to February 2022, 78 cases of patients with severe pneumonia who were diagnosed and treated in our hospital were selected as the research subjects. Accorded to the simple 1:1 allocation principle, the patients were divided into the study group and the matched group of each groups with 39 cases. For example, both groups were given meropenem micro-bolus injection, and the study group and matched group were given high-dose and low-dose ulinastatin treatment, respectively for 7 days. Results: The ICU stay time, fever reduction time, inflammation absorption time and sputum color change time in the study group were shorter than those in the matched group (P<0.05). The total effective rates of the study group was higher than matched group (P<0.05). The serum interleukin-6 (IL-6) and interleukin-17 (IL-17) levels in the two groups after treatment were lower than those before treatment, and the study group were also significantly lower than those in the matched group (P<0.05). The levels of serum angiopoietin-2 in the two groups after treatment were lower than those before treatment, and the levels of serum angiopoietin-2 in the study group after treatment were lower than those in the matched group (P<0.05). Conclusion: The application of high-dose ulinastatin combined with micro-bolus pump meropenem in patients with severe pneumonia can inhibit the expression of serum angiopoietin-2, and also inhibit the expression of serum IL-6 and IL-17, thereby improving the treatment effect. It can improve the clinical symptoms of patients and help patients recover.