Clinical effects of a neutrophil elastase inhibitor, sivelestat, in patients with acute respiratory distress syndrome.
Clinical effects of a neutrophil elastase inhibitor, sivelestat, in patients with acute respiratory distress syndrome.
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DOI：
10.1007/s00540-005-0362-9
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发表时间：
2006-01-01
影响因子：
2.8
通讯作者：
Kanmura, Yuichi
中科院分区：
文献类型：
--
作者：
Okayama, Naoko;Kakihana, Yasuyuki;Kanmura, Yuichi
目的：评价中性粒细胞弹性酶抑制剂西维来司他对急性呼吸窘迫综合征(ARDS)合并全身炎症反应综合征(SIRS)患者呼吸和器官功能的影响以及对病死率的影响。结果：治疗后第1~10天，S组的PaO2/FI(O2)值由119.1+/-51.1升至214.4+/-88.2 mm Hg(P<；0.05)。此外，S组使用呼吸机的天数明显少于C组(16.7+/-5.8vs26.6+/-14.3天；P<；0.05)。S组的重症监护病房住院时间也明显短于C组(18.7±-4.9vs27.5+/-13.5天；P<；0.05)。但两组患者29天的病死率差异无统计学意义。结论：西维来司他仅对合并SIRS的ARDS患者的肺功能有改善作用。
PURPOSE: We assessed the effects of a neutrophil elastase inhibitor, sivelestat, on respiratory and organ functions as well as on the mortality of patients with acute respiratory distress syndrome (ARDS) associated with systemic inflammatory response syndrome (SIRS).METHODS: We retrospectively divided 25 patients who fulfilled the diagnostic criteria for SIRS and ARDS into two groups. One group (S group, n = 12) received a continuous infusion of sivelestat (0.2 mg.kg(-1).h(-1)), and the other did not (C group, n = 13).RESULTS: Between days 1 and 10, the Pa(O2)/FI(O2) ratio in the S group significantly improved from 119.1 +/- 51.1 to 214.4 +/- 88.2 mmHg (P < 0.05). Furthermore, the S group spent significantly fewer days on a ventilator than the C group (16.7 +/- 5.8 vs 26.6 +/- 14.3 days; P < 0.05). The length of the intensive care unit stay was also significantly shorter for the S group than for the C group (18.7 +/- 4.9 vs 27.5 +/- 13.5 days; P < 0.05). However, the mortality rate at 29 days did not statistically differ between the two groups.CONCLUSION: Our results suggested that sivelestat has a beneficial effect only on the pulmonary function of ARDS patients with SIRS.