Therapeutic efficacy

治疗效果
  • 文章类型: Journal Article
    白癜风是一种以表皮黑素细胞损伤为特征的自身免疫性疾病,具有典型的皮肤白斑临床表现。角质形成细胞,与黑素细胞协同工作,以维持皮肤的结构和功能完整性,与白癜风的进展有关。最近的研究报道了一些白癜风患者的角质形成细胞异常增殖和表皮增厚;然而,这些变化与白癜风的临床特征之间的关系尚不清楚。我们评估了白癜风患者表皮厚度的变化及其与临床特征的相关性。与非病变皮肤相比,角质层,可行的表皮,病变皮肤的完整表皮均明显增厚。头部角质层的厚度,脖子,躯干远低于四肢。日晒区角质层厚度高于日晒区,而有活力的表皮厚度减少。总之,我们的研究发现白癜风患者皮损表皮明显增厚,尤其是在阳光照射的地方和四肢。
    Vitiligo is an autoimmune disorder characterized by epidermal melanocyte damage, with the typical clinical manifestation of white patches of skin. Keratinocytes, which work in concert with melanocytes to maintain the structural and functional integrity of the skin, are implicated in the progression of vitiligo. Recent studies have reported abnormal keratinocyte proliferation and epidermal thickening in some patients with vitiligo; however, the relationship between these changes and the clinical characteristics of vitiligo remains unclear. We assessed the changes in epidermal thickness in patients with vitiligo and their correlation with clinical characteristics. Compared to the non-lesional skins, the stratum corneum, viable epidermis, and full epidermis in the lesional skins were all significantly thicker. The thickness of the stratum corneum in the head, neck, and trunk was greatly lower than that in the extremities. The thickness of the stratum corneum in the sun-exposed area was higher than that in the sun-protected area, whereas the thickness of the viable epidermis decreased. In conclusion, our study found that the epidermis in the lesional skins of patients with vitiligo was significantly thickened, especially in the sun-exposed areas and extremities.
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  • 文章类型: Journal Article
    本研究旨在描述中国南方A97S变异型遗传性转甲状腺素蛋白淀粉样多发性神经病(ATTRv-PN)患者的临床特征以及该突变蛋白的分子特征。
    本研究包括15例ATTRv-PN杂合A97S患者和1例纯合A97S患者。通过超高效液相色谱法定量血清TTR四聚体浓度。A97S-TTR的稳定性通过体外尿素介导的色氨酸荧光实验进行评估,和比浊法用于药物反应评估。
    所有患者均为晚发型(≥50岁),平均发病年龄为59.26±5.06岁。患者表现出混合表型,表现为自主神经功能障碍和心脏受累的感觉运动神经病变,如心悸和胸痛。电生理研究表明,感觉和运动神经通常轴突受损。Tafamidis治疗的患者显示出明显更高的TTR四聚体浓度,接近健康控制水平。体外评估表明,A97S-TTR比V122I-TTR在动力学上更稳定,四聚体稳定剂抑制A97S-TTR淀粉样蛋白形成超过70%。
    这项研究为中国南方ATTRv-PNA97S患者的临床和分子特征提供了有价值的见解,特别是关于疾病进展和稳定性特征的差异。
    UNASSIGNED: This study aims to delineate the clinical profiles of the hereditary transthyretin amyloid polyneuropathy (ATTRv-PN) patients with A97S variant from southern China and the molecular characteristics of this mutant protein.
    UNASSIGNED: Fifteen ATTRv-PN patients with heterozygous A97S and one patient with homozygous A97S were included in the study. Serum TTR tetramer concentration was quantified through ultra-performance liquid chromatography. Stabilities of A97S-TTR were assessed through in vitro urea-mediated tryptophan fluorescence experiments, and nephelometry was employed in drug response assessment.
    UNASSIGNED: All patients were late-onset (≥50 years) with a mean age of onset at 59.26 ± 5.06 years old. Patients displayed a mixed phenotype featuring sensory-motor neuropathy with autonomic dysfunction and cardiac involvement, such as palpitations and chest pain. Electrophysiological studies showed generally axonal impairment of sensory and motor nerves. Tafamidis-treated patients showed significantly higher TTR tetramer concentrations, approaching healthy controls\' levels. In vitro assessment showed that A97S-TTR was more kinetically stable than the V122I-TTR, and tetramer stabilisers inhibited A97S-TTR amyloid formation by more than 70%.
    UNASSIGNED: This study provides valuable insights into the clinical and molecular characteristics of ATTRv-PN patients with A97S from South China, particularly regarding the differences in disease progression and stability features.
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  • 文章类型: Journal Article
    目的:Enfortumabvedotin(EV)是转移性尿路上皮癌(mUC)的既定药物疗法;然而,其不良事件(AE)不容忽视。该研究调查了每两周一次EV给药的有效性和安全性。
    方法:在我们机构接受EV的mUC患者被纳入研究。符合条件的患者分为两组:按标准时间表接受EV的患者(标准组)和按双周时间表接受EV的患者(双周组);比较两组之间的治疗结果和AE。
    结果:9例和19例患者分别为标准组和两周组,分别。无进展生存期,总生存率,两组间的总有效率无显著差异.EV管理后的不良事件,如食欲下降(P<0.01),瘙痒(P<0.01),皮疹斑丘疹(P<0.01),贫血(P=.04),和肝功能障碍(P=.04),在标准组中明显更频繁。3级或更高的不良事件,如瘙痒(P=0.03)和斑丘疹(P<0.01),在标准组中明显更频繁。此外,由于不良事件(P=.02),标准组中显著更多的患者不得不给予减量治疗.
    结论:与标准方案相比,每两周一次给予EV可能更安全,而不影响治疗效果。
    OBJECTIVE: Enfortumab vedotin (EV) is an established pharmacotherapy for metastatic urothelial carcinoma (mUC); however, its adverse events (AEs) cannot be overlooked. The study investigated the efficacy and safety of biweekly EV administration.
    METHODS: Patients with mUC who received EV at our institution were included in the study. Eligible patients were classified into two groups as follows: those who received EV on a standard schedule (standard group) and those who received EV on a biweekly schedule (biweekly group); the treatment outcomes and AEs between the two groups were compared.
    RESULTS: Nine and 19 patients were in the standard group and biweekly groups, respectively. The progression-free survival, overall survival, and overall response rate were not significantly different between the two groups. AEs following EV administration, such as decreased appetite (P < .01), pruritus (P < .01), rash maculopapular (P < .01), anemia (P = .04), and liver dysfunction (P = .04), were significantly more frequent in the standard group. Grade 3 or higher AEs, such as pruritus (P = .03) and rash maculopapular (P < .01), were significantly more frequent in the standard group. Furthermore, significantly more patients in the standard group had to be given a reduced dose due to adverse events (P = .02).
    CONCLUSIONS: Biweekly administration of EV may be safer without compromising therapeutic efficacy than the standard schedule.
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  • 文章类型: Journal Article
    探讨80岁以上急性缺血性卒中(AIS)患者再灌注治疗(RT)(包括静脉溶栓-IVT和机械血栓切除术-MT)后的获益(90天mRS评分)和主要并发症(早期症状性颅内出血-SICH)的发生率。
    惠州市中心人民医院2018年9月至2023年收治的80岁以上的AIS患者纳入本研究。SICH上的数据,NIHSS,并对mRS进行了分析。预后良好的定义为90天mRS≤2或恢复到卒中前状态。
    209名患者,80人收到非RT,100例接受IVT,29例接受MT。非RT组的基线NIHSS最低,而MT组的基线NIHSS最高(非RT6.0vsIVT12.0vsMT18.0,P<0.001)。较高的NIHSS与SICH风险增加相关(OR1.083,P=0.032),RT无差异(OR5.194,P=0.129)。按卒中严重程度分层后,RT组的总体SICH发生率较高,但无明显差异。不良预后与较高的入院NIHSS相关,大动脉粥样硬化(LAA)合并心栓塞(CE)引起的中风,和卒中相关性肺炎(SAP)(分别为OR0.902,P<0.001;OR0.297,P=0.029;OR0.103,P<0.001)。与非RT组相比,RT组NIHSS(deltaNIHSS)的降低更大(非RT2.0vsIVT4.0vsMT6.0,P<0.005)。对于严重的AIS,IVT组在90天时预后较好(非RT0%vsIVT38.2%,P=0.039)。分层后,两组之间无90天死亡率差异。
    中风严重程度,而不是RT,是80岁以上AIS患者发生SICH的独立危险因素。重症卒中患者的RT在90天时改善NIHSS,表明RT在这个人群中是安全有效的。需要更大样本的进一步研究来证实这些发现。
    UNASSIGNED: To investigate the benefit (90-day mRS score) and rate of major complications (early symptomatic intracranial hemorrhage-SICH) after reperfusion therapy (RT) (including intravenous thrombolysis -IVT and mechanical thrombectomy -MT) in patients over 80 years with acute ischemic stroke (AIS).
    UNASSIGNED: AIS patients aged over 80 admitted to Huizhou Central People\'s Hospital from September 2018 to 2023 were included in this study. Data on SICH, NIHSS, and mRS were analyzed. A good prognosis was defined as a mRS ≤ 2 or recovery to pre-stroke status at 90 days.
    UNASSIGNED: Of 209 patients, 80 received non-RT, 100 received IVT and 29 underwent MT. The non-RT group had the lowest baseline NIHSS while the MT group had the highest (non-RT 6.0 vs IVT 12.0 vs MT 18.0, P <0.001). Higher NIHSS was associated with increased SICH risk (OR 1.083, P=0.032), while RT was not (OR 5.194, P=0.129). The overall SICH rate in the RT group was higher but not significantly different after stratification by stroke severity. Poor prognosis was associated with higher admission NIHSS, stroke due to large artery atherosclerosis (LAA) combined with cardioembolism (CE), and stroke-associated pneumonia (SAP) (OR 0.902, P<0.001; OR 0.297, P=0.029; OR 0.103, P<0.001, respectively). The RT group showed a greater reduction in NIHSS (delta NIHSS) than the non-RT group (non-RT 2.0 vs IVT 4.0 vs MT 6.0, P<0.005). For severe AIS, the IVT group had a better prognosis at 90 days (non-RT 0% vs IVT 38.2%, P=0.039). No 90-day mortality difference was found between groups after stratification.
    UNASSIGNED: Stroke severity, rather than RT, is an independent risk factor for SICH in AIS patients over 80. RT in severe stroke patients improves NIHSS at 90 days, suggesting RT is safe and effective in this demographic. Further studies with larger samples are required to confirm these findings.
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  • 文章类型: Journal Article
    背景:糖尿病性白内障术后干眼综合征(DES)可严重影响患者的生活质量。因此,有效缓解本病患者的症状具有重要的临床意义。
    目的:探讨重组人表皮生长因子(rhEGF)联合透明质酸钠(SH)滴眼液对糖尿病患者白内障术后DES的临床疗效。
    方法:我们对天津北辰医院82例糖尿病患者进行了回顾性评估,南开大学附属医院2021年4月至2023年4月。将他们分为观察组(42例,rhEGF+SH滴眼液)和对照组(40例,单独使用SH眼药水),根据不同的治疗方案。治疗效果,干眼症状评分,泪膜破裂时间(TFBUT),基本泪液分泌评分[使用SchirmerI测试(SIt)评估],角膜荧光素染色(FL)评分,泪液炎症标记物,治疗过程中的不良反应,比较两组患者的治疗满意度。
    结果:观察组疗效优于对照组。两组均表现出改善的TFBUT和干眼症,以及改善治疗后的SIt和FL评分,观察组的改善更为明显。虽然两组间不良反应无明显差异,观察组患者的治疗满意度较高。
    结论:rhEGF+SH滴眼液可有效改善干眼症和视力损害,具有良好的疗效,不良反应少,和高安全水平。因此,这种治疗应在临床实践中推广。
    BACKGROUND: Dry eye syndrome (DES) after diabetic cataract surgery can seriously affect the patient\'s quality of life. Therefore, effective alleviation of symptoms in patients with this disease has important clinical significance.
    OBJECTIVE: To explore the clinical effect of recombinant human epidermal growth factor (rhEGF) plus sodium hyaluronate (SH) eye drops on DES after cataract surgery in patients with diabetes.
    METHODS: We retrospectively evaluated 82 patients with diabetes who experienced DES after cataract surgery at Tianjin Beichen Hospital, Affiliated Hospital of Nankai University between April 2021 and April 2023. They were classified into an observation group (42 cases, rhEGF + SH eye drops) and a control group (40 cases, SH eye drops alone), depending on the different treatment schemes. The thera-peutic efficacy, dry eye symptom score, tear film breakup time (TFBUT), basic tear secretion score [assessed using Schirmer I test (SIt)], corneal fluorescein staining (FL) score, tear inflammatory markers, adverse reactions during treatment, and treatment satisfaction were compared between the two groups.
    RESULTS: Therapeutic efficacy was higher in the observation group compared with the control group. Both groups showed improved TFBUT and dry eye, as well as improved SIt and FL scores after treatment, with a more pronounced improvement in the observation group. Although no marked differences in adverse reactions were observed between the two groups, treatment satisfaction was higher in the observation group.
    CONCLUSIONS: rhEGF + SH eye drops rendered clinical benefits to patients by effectively ameliorating dry eye and visual impairment with favorable efficacy, fewer adverse reactions, and high safety levels. Thus, this treatment should be promoted in clinical practice.
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  • 文章类型: Journal Article
    胃癌是最常见的癌症之一,被认为是全球第五大最常见的癌症。由于高死亡率,它已经引起了临床医生和研究人员的极大关注。它通常用化疗治疗,放射治疗,和手术。最近,已经开发了其他治疗选择,包括免疫治疗和靶向治疗以及免疫治疗.然而,预后不良,患者生存率有限,对治疗的耐药性仍然是关键问题。改善治疗选择或克服治疗瓶颈,诊断和预后标志物的鉴定,确定最有效的治疗方案,并揭示与治疗策略相关的分子调控是必需的。在这方面,n6-甲基腺苷(m6A)调节被认为是重要的。这种可逆的修饰在进展中起着至关重要的作用,HER2阳性胃癌的发展和治疗。这里,我们通过收集目前的相关研究来讨论m6A修饰在HER2阳性胃癌进展中的作用。我们进一步讨论了m6A修饰与HER2阳性胃癌治疗效果的关联,并列举了一些例子。我们得出结论,m6A的修饰可能是改善HER2阳性胃癌患者预后和生存率的新策略。
    Gastric cancer is one of the most common cancers and is considered the 5th most frequent occurring cancer worldwide. It has gained great attention from the clinicians and researchers because of high mortality rate. It is generally treated with chemotherapy, radiotherapy, and surgery. Recently, additional treatment options including immunotherapy and targeted therapy and immunotherapy have been developed. However, poor prognosis, limited survival rate of patients, and drug resistance to treatment remain critical problems. To improve treatment options or to overcome the bottleneck of treatment, identification of diagnostic and prognostic markers, determining the most effective therapeutic options, and uncovering the molecular regulations associated with treatment strategies are required. In this regard n6-methyladenosine (m6A) regulation is considered important. This reversible modification plays a crucial role in progression, development and treatment of HER2-positive gastric cancer. Here, we discuss the role of m6A modification in HER2-positive gastric cancer progression through collecting related studies at present. We further discuss the association of m6A modification with therapeutic efficacy in HER2-positive gastric cancer and list some examples. We conclude that modification of m6A can be a new strategy for improving the prognosis and survival rate of HER2-positive gastric cancer patients.
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  • 文章类型: Journal Article
    滋养层细胞表面抗原2(Trop2)在一系列实体瘤和多个致癌信号通路的参与者中过度表达,使其成为有吸引力的治疗靶点。在过去的十年里,各种Trop2靶向疗法的快速发展,特别是以抗体-药物偶联物(ADC)的出现为标志,彻底改变了治疗意见有限的Trop2阳性肿瘤患者的结果,例如三阴性乳腺癌(TNBC)。这篇综述全面总结了Trop2靶向治疗的进展,包括ADC,抗体,多特异性药物,免疫疗法,癌症疫苗,和小分子抑制剂,随着对他们设计的深入讨论,行动机制(MOA),和限制。此外,我们强调了这些新兴的Trop2靶向药物的临床研究进展,重点关注其临床应用和对肿瘤的治疗效果。此外,我们提出了未来研究的方向,例如加强我们对Trop2的结构和生物学的理解,探索最佳组合策略,并根据Trop2测试方法定制精确处理。
    Trophoblast cell surface antigen 2 (Trop2) is overexpressed in a range of solid tumors and participants in multiple oncogenic signaling pathways, making it an attractive therapeutic target. In the past decade, the rapid development of various Trop2-targeted therapies, notably marked by the advent of the antibody-drug conjugate (ADC), revolutionized the outcome for patients facing Trop2-positive tumors with limited treatment opinions, such as triple-negative breast cancer (TNBC). This review provides a comprehensive summary of advances in Trop2-targeted therapies, including ADCs, antibodies, multispecific agents, immunotherapy, cancer vaccines, and small molecular inhibitors, along with in-depth discussions on their designs, mechanisms of action (MOAs), and limitations. Additionally, we emphasize the clinical research progress of these emerging Trop2-targeted agents, focusing on their clinical application and therapeutic efficacy against tumors. Furthermore, we propose directions for future research, such as enhancing our understanding of Trop2\'s structure and biology, exploring the best combination strategies, and tailoring precision treatment based on Trop2 testing methodologies.
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  • 文章类型: Journal Article
    介绍了CD4+细胞刺激三磷酸腺苷(sATPCD4)水平用于非小细胞肺癌(NSCLC)化疗后免疫监测的探索,本研究旨在探讨其在衡量NSCLC患者疾病进展(PD)潜在风险方面的有效性.因此,共有89例晚期非小细胞肺癌患者,2022年8月15日至2023年8月30日在广州医科大学附属第五医院接受化疗(广州,中国),进行了回顾性研究。将患者分为PD(n=21)和疾病稳定性(非PD;n=68)组,并比较其临床数据。使用受试者工作特征(ROC)曲线确定用于预测PD的阈值。进行多因素logistic回归分析以评估外周血标志物与PD发生率之间的关系。因此,化疗后,白细胞计数的显著差异,PD组和非PD组患者之间获得了未刺激的CD4细胞ATP和sATPCD4水平(P<0.05)。此外,与非PD组相比,PD组sATPCD4水平显着降低。此外,ROC分析显示PD的预测阈值为224.5ng/ml[曲线下面积=0.887;95%置信区间,0.811-0.963]。此外,与高免疫组(ATP>224.5ng/ml;P<0.0001)相比,低免疫组(ATP<224.5ng/ml)患者的PD风险更高.最后,多因素logistic回归分析提示sATPCD4可作为预测NSCLC进展的独立因素。总的来说,本研究预测免疫功能可能与NSCLC患者的PD风险相关。
    Introducing the exploration of stimulated CD4+ cells adenosine triphosphate (sATPCD4) levels for immune monitoring post non-small cell lung cancer (NSCLC) chemotherapy, the present study aimed to investigate its efficacy in gauging the potential risk of disease progression (PD) in patients with NSCLC. Therefore, a total of 89 patients with advanced NSCLC, who underwent chemotherapy between August 15 2022 and August 30 2023 at the Fifth Affiliated Hospital of Guangzhou Medical University (Guangzhou, China), were retrospectively studied. Patients were divided into the PD (n=21) and disease stability (non-PD; n=68) groups and their clinical data were compared. The thresholds for predicting PD were identified using receiver operating characteristics (ROC) curves. Multivariate logistic regression analysis was carried out to assess the association between peripheral blood markers and the incidence of PD. Therefore, post-chemotherapy, significant differences in white blood cell count, non-stimulated CD4+ cells ATP and sATPCD4 levels were obtained between patients in the PD and non-PD groups (P<0.05). In addition, sATPCD4 levels were notably decreased in the PD group compared with the non-PD group. Furthermore, ROC analysis revealed that the predictive threshold for PD was 224.5 ng/ml [area under the curve=0.887; 95% confidence interval, 0.811-0.963]. Additionally, patients with low immunity (ATP <224.5 ng/ml) exhibited a higher risk of PD compared with the high-immunity group (ATP >224.5 ng/ml; P<0.0001). Finally, multivariate logistic regression analysis suggested that sATPCD4 could serve as an independent factor for predicting NSCLC progression. Overall, the current study predicted that immune function could be possibly associated with the risk of PD in patients with NSCLC.
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  • 文章类型: Journal Article
    前列腺癌是一种常见的恶性肿瘤,预后不佳。促黄体激素释放激素(LHRH)受体在这些癌细胞中过度表达,LHRH-十肽可以特异性结合。合成并表征了脂质-聚乙二醇缀合的新型LHRH-十肽类似物(D-P-HLH)。采用冷均质化技术制备了D-P-HLH包被的抗癌药物阿霉素(DX)固体脂质纳米粒(F-DX-SLN),X射线衍射,X射线光电子能谱,差示扫描量热法,动态光散射,电子显微镜,截留效率,和药物释放概况研究。F-DX-SLN通过减少化疗的副作用而允许位点特异性DX递送。癌细胞可以通过靶向特异性受体精确摄取F-DX-SLN,增强肿瘤部位的细胞毒性。通过MTT测定F-DX-SLN对PC3/SKBR3细胞的功效表明,F-DX-SLN比DX和/或DX-SLN更具细胞毒性。流式细胞术和共聚焦显微镜研究进一步支持F-DX-SLN在靶向LHRH过表达的癌细胞中增加了细胞内吸收能力。F-DX-SLN确保高凋亡潜能,明显更大的线粒体跨膜去极化作用,以及胱天蛋白酶的激活,更长的半衰期,和更大的血浆浓度。F-DX-SLN/DX-SLN用99m放射性标记;闪烁显像研究在PC3荷瘤裸鼠中确立了其肿瘤选择性。制剂在癌症治疗中的功效,体内治疗功效测试,并进行了组织病理学研究。结果清楚地表明,F-DX-SLN表现出抗癌药物的持续和优越的靶向给药,从而开辟了具有精确控制和靶向作用的药物递送系统的可能性。F-DX-SLN还可以提供一种纳米癌症诊断方法,提高前列腺癌治疗的疗效。
    Prostate cancer is a prevalently detected malignancy with a dismal prognosis. Luteinizing-hormone-releasing-hormone (LHRH) receptors are overexpressed in such cancer cells, to which the LHRH-decapeptide can specifically bind. A lipid-polyethylene glycol-conjugated new LHRH-decapeptide analogue (D-P-HLH) was synthesized and characterized. D-P-HLH-coated and anticancer drug doxorubicin (DX)-loaded solid lipid nanoparticles (F-DX-SLN) were formulated by the cold homogenization technique and characterized by Fourier transform infrared spectroscopy, X-ray diffraction, X-ray photoelectron spectroscopy, differential scanning calorimetry, dynamic light scattering, electron microscopy, entrapment efficiency, and drug-release profile studies. F-DX-SLN allows site-specific DX delivery by reducing the side effects of chemotherapy. Cancer cells could precisely take up F-DX-SLN by targeting specific receptors, boosting the cytotoxicity at the tumor site. The efficacy of F-DX-SLN on PC3/SKBR3 cells by the MTT assay revealed that F-DX-SLN was more cytotoxic than DX and/or DX-SLN. Flow cytometry and confocal microscopic studies further support F-DX-SLNs\' increased intracellular absorption capability in targeting LHRH overexpressed cancer cells. F-DX-SLN ensured high apoptotic potential, noticeably larger mitochondrial transmembrane depolarization action, as well as the activation of caspases, a longer half-life, and greater plasma concentration. F-DX-SLN/DX-SLN was radiolabeled with technetium-99m; scintigraphic imaging studies established its tumor selectivity in PC3 tumor-bearing nude mice. The efficacy of the formulations in cancer treatment, in vivo therapeutic efficacy tests, and histopathological studies were also conducted. Results clearly indicate that F-DX-SLN exhibits sustained and superior targeted administration of anticancer drugs, thus opening up the possibility of a drug delivery system with precise control and targeting effects. F-DX-SLN could also provide a nanotheranostic approach with improved efficacy for prostate cancer therapy.
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  • 文章类型: Journal Article
    目的:本对比分析旨在探讨盐酸西维来司钠(SSH)联合乌司他丁(UTI)治疗脓毒症合并急性呼吸窘迫综合征(ARDS)的疗效。
    方法:84例脓毒症合并ARDS患者为对照组和观察组。每组42例。对照组在常规治疗基础上静脉注射UTI,观察组在对照组的基础上注射SSH。两组均连续治疗7天,观察两组的治疗效果和疗效。Murray肺损伤评分(MLIS),序贯器官衰竭评估(SOFA)比较了急性生理学和慢性健康评估II(APACHEII)。呼吸功能的变化,炎症因子,并对氧化应激指标进行评估。记录药物不良反应发生情况。
    结果:观察组总有效率(95.24%)高于对照组(80.95%)(P<0.05)。机械通气时间,重症监护病房(ICU)住院时间,观察组抗菌药物使用时间短于对照组,多器官功能障碍综合征发生率低于对照组(P<0.05)。观察组患者死亡率(35.71%)低于对照组(52.38%),但两组间差异无统计学意义(P>0.05)。MLIS,SOFA,观察组患者的APACHEⅡ评分低于对照组(P<0.05)。治疗后,呼吸功能,炎症,观察组患者的氧化应激水平均有改善(P<0.05)。两组不良反应比较差异无统计学意义(P>0.05)。
    结论:SSH加UTI的组合可改善肺损伤和肺通气功能,减少脓毒症和ARDS患者的炎症和氧化应激。
    OBJECTIVE: This comparative analysis aimed to investigate the efficacy of Sivelestat Sodium Hydrate (SSH) combined with Ulinastatin (UTI) in the treatment of sepsis with acute respiratory distress syndrome (ARDS).
    METHODS: A control group and an observation group were formed with eighty-four cases of patients with sepsis with ARDS, with 42 cases in each group. The control group was intravenously injected with UTI based on conventional treatment, and the observation group was injected with SSH based on the control group. Both groups were treated continuously for 7 days, and the treatment outcomes and efficacy of both groups were observed. The Murray Lung Injury Score (MLIS), Sequential Organ Failure Assessment (SOFA), and Acute Physiology and Chronic Health Evaluation II (APACHE II) were compared. Changes in respiratory function, inflammatory factors, and oxidative stress indicators were assessed. The occurrence of adverse drug reactions was recorded.
    RESULTS: The total effective rate in the observation group (95.24%) was higher than that in the control group (80.95%) (P < 0.05). The mechanical ventilation time, intensive care unit (ICU) hospitalization time, and duration of antimicrobial medication in the observation group were shorter and multiple organ dysfunction syndrome incidence was lower than those in the control group (P < 0.05). The mortality rate of patients in the observation group (35.71%) was lower than that in the control group (52.38%), but there was no statistically significant difference between the two groups (P > 0.05). MLIS, SOFA, and APACHE II scores in the observation group were lower than the control group (P < 0.05). After treatment, respiratory function, inflammation, and oxidative stress were improved in the observation group (P < 0.05). Adverse reactions were not significantly different between the two groups (P > 0.05).
    CONCLUSIONS: The combination of SSH plus UTI improves lung injury and pulmonary ventilation function, and reduces inflammation and oxidative stress in patients with sepsis and ARDS.
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