目的 觀察卡托普利治療重癥急性胰腺炎肺損傷的臨床療效。方法 選取2014年4月-2016年3月鄂東醫(yī)療集團(tuán)黃石市中心醫(yī)院收治的重癥急性胰腺炎肺損傷患者82例，隨機(jī)分為對(duì)照組和治療組，每組各41例。對(duì)照組給予常規(guī)治療，包括禁飲禁食，補(bǔ)液，維持水、電解質(zhì)及酸堿平衡，持續(xù)胃腸減壓，抑制胰酶分泌，防治胰腺繼發(fā)感染，靜脈營(yíng)養(yǎng)支持。治療組在對(duì)照組基礎(chǔ)上靜脈滴注卡托普利注射液，50 mg加入到0.9%氯化鈉溶液100 mL中，1次/d。兩組患者均連續(xù)治療7 d。觀察兩組的臨床療效，比較兩組肺功能指標(biāo)、白細(xì)胞介素-6（IL-6）和腫瘤壞死因子-α（TNF-α）。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為80.5%、92.7%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組血氧分壓（PaO₂）和PaO₂/吸入氧濃度（FiO₂）均顯著升高，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的升高程度明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組IL-6和TNF-α均顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的下降程度明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 卡托普利治療重癥急性胰腺炎肺損傷具有較好的臨床療效，能改善肺功能，降低炎性因子，安全性較好，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of captopril in treatment of severe acute pancreatitis associated lung injury. Methods Patients (82 cases) with severe acute pancreatitis associated lung injury in Huangshi Central Hospital of Edong Healthcare Group from April 2014 to March 2016 were randomly divided into control and treatment groups, and each group had 41 cases. Patients in the control group were given conventional treatment, including fasting, fluid infusion, maintain water, electrolyte and acid-base balance, continuous gastrointestinal decompression, inhibiting pancreatic secretion, prevention and treatment of secondary infection of the pancreas, and parenteral nutrition support. Patients in the treatment group were iv administered with Captopril Injection on the basis of the control group, 50 mg added into normal saline 100 mL, once daily. Patients in two groups were treated for 7 d. After treatment, the clinical efficacies were evaluated, and lung function indexes, IL-6, and TNF-α in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 80.5% and 92.7%, respectively, and there was difference between two groups (P<0.05). After treatment, PaO₂ and PaO₂/FiO₂ in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, IL-6 and TNF-α in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Captopril has clinical curative effect in treatment of severe acute pancreatitis associated lung injury, can improve lung function, decrease inflammatory factors, with good safety, which has a certain clinical application value.