西维来司他钠联合乌司他丁治疗脓毒症所致急性呼吸窘迫综合征的临床疗效及对生存率的影响OA

Objective:To explore the clinical efficacy of sivelestat sodium combined with ulinastatin and its influence on the survival rate of patients with sepsis-induced acute respiratory distress syndrome(ARDS).Methods:A total of 102 patients with sepsis-induced ARDS admitted from February 2022 to February 2025 were prospectively selected and randomly divided into control group and observation group by random number table method,with 51 cases in each group.The control group received ulinastatin monotherapy;the observation group received sivelestat sodium combined with ulinastatin.The severity of disease[evaluated by Sequential Organ Failure Assessment(SOFA)score,Murray Lung Injury Score(MLIS)],mechanical ventilation duration,pulmonary oxygenation indicators[arterial partial pressure of oxygen/fraction of inspired oxygen(PaO2/FiO2),extravascular lung water index(ELWI)],inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)],serum markers[soluble urokinase plasminogen activator receptor(suPAR),endothelial cell-specific molecule-1(ESM-1),procalcitonin(PCT)]were compared,and the 14-day survival rate was counted.Results:There were no significant differences in mechanical ventilation duration,suPAR,ESM-1 and PCT between the two groups after 7 days of treatment(P>0.05).After 7 days of treatment,SOFA score,MLIS score,ELWI,IL-6,TNF-α and CRP of the observation group were lower than those of the control group,while PaO2/FiO2 was higher(P<0.05).The 14-day survival rate of the observation group was higher than that of the control group(98.04%vs 86.27%,Log-rank x2=4.867,P=0.027).Conclusion:Sivelestat sodium combined with ulinastatin can significantly improve pulmonary oxygenation,inhibit inflammatory response and increase short-term survival rate in patients with sepsis-induced ARDS.