RESUMO
Objective To observe the clinical efficacy of sivelestat sodium combined with ulinastatin in the treatment of sepsis-induced acute respiratory distress syndrome(ARDS).Methods One hundred and four patients with sepsis-induced ARDS had admitted to our hospital from January 2020 to May 2023 were selected and randomly divided into a control group(routine treatment plus sivelestat sodium)and combination group(routine treatment plus sivelestat sodium and ulinastatin)by a computer random number generator,52 in each group.Murray lung injury score(MLIS),sequential organ failure assessment(SOFA)score,extravascular lung water index(ELWI),arterial blood oxygen partial pressure/fraction of inspired oxygen(PaO2/FiO2),white blood cell count(WBC),neutrophil percentage(NEUT%),and levels of endothelial cell specific molecule-1(ESM-1),soluble urokinase-type plasminogen activator receptor(suPAR)and interleukin-6(IL-6)were compared between the two groups before and after treatment.The recovery speed,prognosis and adverse reactions were compared between the two groups.Results T-test showed there were no significant differences in MLIS score,SOFA score,ELWI,PaO2/FiO2,WBC,NEUT%,ESM-1,suPAR and IL-6 levels between the control group and the combination group before treatment(P>0.05).After treatment,MLIS score,SOFA score,ELWI,WBC,NEUT%,ESM-1,suPAR and IL-6 levels in the combination group were lower than those in the control group(P<0.05),and PaO2/FiO2 was higher than that in the control group(P<0.05).Time to mechanical ventilation and length of ICU stay in the combination group were shorter than those in the control group(P<0.05),and the 28-day mortality rate was lower than that in the control group(P<0.05).No serious adverse reactions occurred in both groups during the treatment period.Conclusion Sivelestat sodium combined with ulinastatin can reduce lung injury and inflammatory response,accelerate recovery speed,improve lung function and prognosis in patients with sepsis-induced ARDS,and the therapy has higher safety.