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目的：探讨乌司他丁对慢性阻塞性肺疾病合并呼吸衰竭患者血清环氧化酶2（cyclooxygenase-2，COX-2），前列腺素E2 （prostaglandin E2，PGE2）及磷脂酶A2（phospholipase A2，PLA2）浓度的影响。方法：选取2014 年1 月至2015 年1 月我院收治的 80 例慢性阻塞性肺疾病患者，按照单盲法均分为实验组和对照组。对照组给予慢性阻塞性肺疾病常规对症治疗；实验组在对照组常规对症治疗的基础上，给予乌司他丁治疗。检测治疗前后患者COX-2、PGE2 及PLA2 血清浓度。结果：两组COX-2、PGE2 及 PLA2 血清浓度，实验组治疗后均显著低于治疗前（P<0.05）；对照组治疗后均低于本组治疗前，（P<0.05）。实验组治疗前与对照组无显著差异（P>0.05）；治疗后，实验组COX-2、PGE2、PLA2 血清浓度显著低于对照组，治疗后实验组肺功能FEV1、FVC均显著优于对照组（P<0.05）。结论：乌司他丁治疗慢性阻塞性肺疾病合并呼衰患者能够显著降低其COX-2、PGE2 及PLA2 血清浓度，有效改善患者炎症反应、细胞损伤及临床症状，为临床积极治疗慢性阻塞性肺疾病提供新的思路。

英文摘要:

Objective:To investigate the effects of ulinastatin on the serum level of cyclooxygenase-2 (COX-2), prostaglandin E2 (PGE2) and phospholipase A2(PLA2) in the patients with chronic obstructive pulmonary disease(COPD) combined with respiratory failure.Methods:80 patients with COPD were randomly selected in our hospital from January 2014 to January 2015 and divided into two groups that 40 cases in the experimental group and 40 cases in the control group. The control group was given routine treatment, and the experimental group was given ulinastatin treatment. Then the levels of COX-2, PGE2 and PLA2 in the two groups were detected and compared before and after the treatment.Results:After treatment, the levels of COX-2, PGE2 and PLA2 in the two groups were significantly lower than before treatment (P<0.05), and the experimental group was significantly lower than that of the control group (P<0.05). After the treatment, the FEV1 and FVC were significantly better in the experimental group than those of the control group (P<0.05).Conclusion:Ulinastatin can significantly reduce the serum levels of COX-2, PGE2 and PLA2 in the patients with COPD combined with respiratory failure, and effectively improve inflammatory reaction, cell damage and clinical symptoms of the patients, which can provide a new idea for efficient treatment of COPD in clinic.

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