Clinical Study on the Treatment of Post-Traumatic ARDS with Sivelestat Sodium Combined with Dexamethasone

TIAN Xiaohong; LI Wanhua

doi:10.3969/j.issn.2096-305X.2025.05.008

Abstract：Objective To investigate the clinical efficacy of sivelestat sodium combined with aexamethasone in the treatment of post-traumatic acute respiratory distress syndrome(ARDS).Methods A total of 80 patients with ARDS at Kaifeng People's Hospital from October 2022 to October 2024 were randomly selected for the study.Using a random number table,the patients were equally assigned to a control group(n=40)and an observation group(n=40).The control group received dexamethasone sodium phosphate injection,while the observation group received a combination of dexamethasone sodium phosphate injection and sivelestat sodium.The following outcomes were compared between the two groups:Murray Lung Injury Score(MLIS),Sequential Organ Failure Assessment(SOFA)score,serum inflammatory markers including procalcitonin(PCT),interleukin-6(IL-6),and C-reactive protein(CRP)levels,oxygenation index(PaO2/FiO2),blood lactic acid(Lac)concentration,carbonic anhydrase(CA)activity,adverse events,as well as clinical recovery and prognosis.Results Some patients in both groups died after treatment.The mortality rate of the observation group was 45.00％,which showed no statistical significance compared with the control group(P＞0.05).The mechanical ventilation time(8.10±2.06)days was significantly lower than that of the control group(P＜0.05).However,the ICU hospitalization time(11.83±2.42)days and the mortality rate of 45.00％showed no statistical significance compared with the control group(P＞0.05).After treatment,the MLIS(5.10±2.16)and SOFA(7.23±2.86)scores in the observation group were significantly lower than those in the control group(P＜0.05).After treatment,the observation group had lower levels of PCT(0.35±0.04)ng/mL,IL-6(121.39±16.37)pg/mL,and CRP(16.26±3.41)mg/L compared to the control group(P＜0.05).The PaO2/FiO2(90.82±10.82)mmHg in the observation group was higher than that in the control group,while Lac(3.59±0.53)mmol/L was lower(P＜0.05).The total incidence of adverse reactions in the observation group(10.00％)was slightly higher than that in the control group(5.00％),but the difference was not statistically significant(P＞0.05).The mechanical ventilation time(8.10±2.06)days in the observation group was significantly shorter than that in the control group(P＜0.05),while there was no statistically significant difference in ICU length of stay(11.83±2.42)days or mortality rate(45.00％)between the two groups(P＞0.05).Conclusion The combination of sivelestat sodium and dexamethasone in the treatment of post-traumatic ARDS significantly improves lung injury scores,reduces serum inflammatory factor levels,increases the oxygenation index,decreases lactate levels,and shortens mechanical ventilation time,demonstrating favorable efficacy.However,limitations remain in terms of ICU length of stay and mortality reduction,necessitating further research to optimize the treatment regimen.