文章来源：免疫炎症事业部中央市场部

摘要信息：引发重症肺炎/低氧/ARDS的核心关键词：肾移植术后、胆囊炎、全身炎症反应、移植肾功能不全；腹腔镜胰头十二指肠切除术、术后、老年、梗阻性黄疸；脑梗取栓、人鼻病毒、肺炎克雷伯菌、吸入性、急性呼吸窘迫综合征

文章来源：免疫炎症事业部中央市场部

摘要信息：2025年新增科室会幻灯、希为纳VS乌司他丁

文章来源：免疫炎症事业部中央市场部

摘要信息：西维来司他钠在急性胰腺炎中的保护作用

文章来源：中国知网

摘要信息：目的 探析西维来司他钠联合俯卧位通气在急性肺损伤（ALI）/急性呼吸窘迫综合征（ARDS）中的疗效。方法 确认研究样本为50例ALI/ARDS患者，来源潍坊市第二人民医院，研究起止时间2023年10月至2024年9月，以随机数字法设计分组，分成对照组（25例，常规治疗）和试验组（25例，在对照组的基础上增加静脉泵入西维来司他钠联合俯卧位通气治疗）。评价组间血气指标[动脉血氧饱和度（SaO2）、动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）]、临床指标、病死率及并发症发生情况。结果 试验组血气指标高于对照组（P<0.05）；试验组症状缓解时间及住院时间均短于对照组（P<0.05）；试验组并发症总发生率低于对照组（P<0.05）。结论 西维来司他钠与俯卧位通气联合使用，有助于改善ALI/ARDS患者的血气水平，加速症状缓解，缩短住院时间，并降低并发症的发生率。

文章来源：PubMed

摘要信息：Background. Since the 2012 Berlin Definition of the Acute Respiratory Distress Syndrome (ARDS), several developments have supported the need for an expansion of the definition, including the use of high flow nasal oxygen (HFNO), expanding use of pulse oximetry in place of arterial blood gases, use of ultrasound for chest imaging, and the need for applicability in resource-limited settings. Methods. A Consensus Conference of 32 critical care ARDS experts was convened, had six virtual meetings (June 2021-March 2022), and subsequently obtained input from members of several critical care societies. The goal was to develop a definition that would: (1) identify patients with the currently accepted conceptual framework for ARDS; (2) facilitate rapid ARDS diagnosis for clinical care and research; (3) be applicable in resource-limited settings; (4) be useful for testing specific therapies; and (5) be practical for communication to patients and caregivers. Results. The committee made four main recommendations: (1) Include HFNO with a minimum flow rate of  30 liters/min; (2) Use arterial oxygen tension (PaO2)/FiO2  300 mmHg or SpO2/FiO2 < 315 (if SpO2  97%) to identify hypoxemia; (3) Retain bilateral opacities for imaging criteria but add ultrasound as an imaging modality, especially in resource-limited areas; and (4) In resource-limited settings, do not require PEEP, oxygen flow rate, or specific respiratory support devices. Conclusions. We propose a New Global Definition of ARDS that builds on the Berlin Definition. The recommendations also identify areas for future research, including the need for prospective assessments of feasibility, reliability, and prognostic validity of the proposed Global Definition.

文章来源：PubMed

摘要信息：Objective:We aimed to evaluate the protective effects of sivelestat sodium on the basis of corticosteroid therapy in patients with moderate-to-severe acute respiratory distress syndrome (ARDS).Methods:We retrospectively investigated 127 patients with confirmed moderate-to-severe ARDS treated in the intensive care unit (ICU) at Dazhou Central Hospital. Patients were divided into the control group (corticosteroids alone) and the combination therapy of steroids and sivelestat sodium (CTSSS) group according to the therapeutic interventions. The primary outcome was in-hospital mortality. And the baseline characteristics and laboratory findings of patients were collected for analysis.Results:The overall mortality rate in 127 patients was 48.8%. There was no statistically significant difference in in-hospital mortality between the CTSSS group and the control group (45.3% vs. 56.1%). In the subgroup of patients aged < 80 years or with an Acute Physiology and Chronic Health Evaluation (APACHE) II score < 30, CTSSS could reduce the risk of mortality (odds ratio [OR] = 0.41, 95% confidence interval [CI], 0.17-0.96, p=0.041; OR = 0.31, 95% CI, 0.13-0.77, p=0.012; respectively). Among patients aged 80 years or older, those with CTSSS exhibited a significantly elevated risk of mortality (OR = 13; 95% CI, 1.20-140.73; p=0.035).Conclusion:Compared with corticosteroids alone, CTSSS could improve oxygenation index, increase lymphocyte count, protect extrapulmonary organs and reduce in-hospital mortality rate in patients with moderate-to-severe ARDS in specific subgroups (age < 80 years or APACHE II score < 30). It might be advisable to avoid CTSSS in moderate-to-severe ARDS patients aged 80 years or older. Prospective studies involving larger sample sizes are needed to verify these findings.

文章来源：PubMed

摘要信息：Objective:Sivelestat may reduce postoperative pulmonary injury after total arch replacement (TAR). This study aimed to evaluate whether the preoperative PaO2/FiO2(P/F) ratio affects the efficacy of sivelestat in reducing postoperative pulmonary injury in patients with acute aortic dissection (AAD) who underwent TAR using deep hypothermic circulatory arrest (DHCA). Methods:Data of patients with AAD who underwent TAR using DHCA in a tertiary hospital between February 1, 2022, and December 30, 2022, were retrospectively reviewed. The patients were divided into the sivelestat and control groups. Three subgroup analyses were performed based on the postoperative P/F ratio. The primary clinical outcomes were assessed to determine the efficacy and safety of sivelestat in managing postoperative pulmonary dysfunction in patients undergoing cardiopulmonary bypass. Results:A total of 187 patients were included, with 95 in the sivelestat group and 92 in the control group. No significant differences were found in the clinical variables between the two groups (all P > 0.05), except for some improvements in the inflammatory biomarker levels (including white blood cell count, neutrophil count, and C-reactive protein). Subgroup analysis revealed that sivelestat treatment significantly increased the P/F ratio on the 4th day and 3rd day after TAR in patients with mild lung injury (P = 0.02) and moderate lung injury (P = 0.03), respectively. Additionally, sivelestat reduced the levels of several postoperative inflammatory biomarkers in both subgroups. Conclusions:Among patients with AAD with mild or moderate preoperative lung injury, defined by a low P/F ratio, sivelestat significantly improved the postoperative P/F ratio and attenuated inflammatory responses after TAR. These findings suggest an important avenue for further research.

文章来源：中国知网

摘要信息：目的 探讨西维来司他钠治疗急性呼吸窘迫综合征（ARDS）的临床疗效及其应用价值。方法 回顾性分析2022年10月至2023年10月平顶山市第一人民医院诊治的80例ARDS患者分为对照组（40例）、观察组（40例）。对照组接受常规治疗，观察组接受西维来司他钠治疗。统计对比两组临床疗效及治疗前后生理生化指标[动脉血氧饱和度（SaO2）、动脉血氧分压（PaO2）]、Murray肺损伤评分、急性生理功能和慢性健康状况评分系统Ⅱ（APACHEⅡ）、炎症因子[超敏C反应蛋白（hs-CRP）、白细胞介素-6（IL-6）、降钙素原（PCT）]、血管内皮功能[血管生成素-2（Ang-2）、可溶性晚期糖基化终产物受体（sRAGE）、内皮素-1（ET-1）、一氧化氮（NO）]。比较两组不良反应发生率与病死率。结果 观察组总有效率（90.00%）较对照组（72.50%）升高（P<0.05）;与对照组比较，观察组治疗后SaO2、PaO2升高，Murray评分、APACHEⅡ评分降低（P<0.05）;与对照组比较，观察组治疗后血清hs-CRP、IL-6、PCT、Ang-2、sRAGE、ET-1水平降低，血清NO水平升高（P<0.05）;两组不良反应发生率比较差异无统计学意义（P>0.05）;观察组病死率低于对照组（P<0.05）。结论 西维来司他钠治疗ARDS的效果确切，可改善血气指标，抑制炎症反应，减轻肺损伤，改善血管内皮功能，降低病死率，具有一定安全性。

文章来源：PubMed

摘要信息：背景：缺血再灌注损伤（IRI）常导致肾脏损害。虽然中性粒细胞胞外陷阱（NETs）的存在一直被观察到，但它们对IRI的具体影响尚未确定。西维来司他钠是中性粒细胞弹性酶的抑制剂，对NET的形成至关重要，可能为肾脏IRI提供治疗方法，值得进一步研究。 方法：建立小鼠早期肾IRI模型，经损伤标志物和组织学检查证实。免疫荧光和Western blot证实NETs在肾I/R中的作用。通过一套全面的方法进一步评估肾功能和病理，包括周期性酸希夫染色（PAS）和末端脱氧核苷酸转移酶dUTP Nick末端标记（TUNEL）染色，酶联免疫吸附试验（ELISA），实时肾小球滤过率（RT-GFR）监测，聚合酶链反应（PCR），生化分析，以及额外的Western blot和免疫荧光试验。 结果：我们首先量化了肾IRI小鼠的NET表达，并在24小时达到峰值。随后，给予西维来司他钠治疗，导致MPO、CitH3降低，并减轻了肾小管损伤。此外，它还导致血清肌酐、血尿素氮（BUN）、中性粒细胞明胶酶相关脂钙蛋白（NGAL）和肾损伤分子-1 （KIM-1）水平降低。降低肾组织炎症标志物白介素-6 （IL-6）和肿瘤坏死因子-α (TNF-α)的丰度，减轻氧化应激指标丙二醛（MDA）和4羟基烯醛（4HNE）的水平，并伴有肾I/R小鼠肾细胞凋亡减少和GFR升高。 结论：西维来司他钠通过下调中性粒细胞NETs，减少炎症、氧化应激和细胞凋亡，从而改善肾IRI，从而增强肾功能。

文章来源：中国知网

摘要信息：目的 探讨儿童使用西维来司他钠治疗脓毒症和急性呼吸窘迫综合征的安全性和有效性。方法 回顾性收集空军军医大学第一附属医院儿科重症监护室2021年1月至2024年7月收治的使用西维来司他钠的重症患儿的资料，并以“西维来司他钠”、“脓毒症”、“急性呼吸窘迫综合征”和“儿童”为中文检索词检索知网、万方和维普等数据库，以“Sivelestat sodium”、“Sepsis”、“Respiratory distress syndrome”和“Child”为英文检索词检索PubMed、Embase、Web of Science数据库，检索日期截至2024年7月30日。结果 共收集到9例病例，其中我院6例，文献报道3例，年龄中位数为4岁5个月，男性5例（55.6%）。9例患儿中，5例在用药后白细胞计数（WBC）、降钙素原（PCT）和白介素-6（IL-6）较前明显好转，3例C反应蛋白（CRP）明显改善；4例患有脓毒症患儿用药后PCT均明显改善，其中3例IL-6明显改善，2例WBC明显下降。在7例患有急性呼吸窘迫综合征或呼吸衰竭的患儿中，有2例在用药后氧合指数（PaO2/FiO2）明显改善。结论 西维来司他钠有助于降低WBC、IL-6、PCT和CRP的水平，抑制重症患儿者体内炎症反应，有助于改善急性呼吸窘迫患儿PaO2/FiO2比值。