Therapeutic effect and mechanism of sivelestat sodium on acute lung injury: A randomized controlled trial

Background: To observe the therapeutic effect of sivelestat sodium on acute lung injury and explore its mechanism. Methods: Eighty-six patients with acute lung injury admitted from April 2022 to December 2023 were selected as the research objects. According to the principle of randomized control and single-blindness, they were randomly divided into the observation group (43 cases) and the control group (43 cases). The control group was given conventional symptomatic treatment, while the observation group was treated with sivelestat sodium on this basis. The mechanical ventilation, ICU stay, hospital stay, and 28-day mortality were compared between the 2 groups. The differences in pulmonary function, inflammatory factors, oxygenation index (PaO 2 /FiO 2 ), and respiratory rate (RR) between the 2 groups were detected and compared. Results: The duration of mechanical ventilation, ICU stay, and hospitalization in the observation group were significantly shorter than those in the control group, while there was no difference in 28-day mortality between the 2 groups ( P > .05). Before treatment, pulmonary function indexes were compared between the 2 groups ( P > .05). On the 5th and 7th days of treatment, the vital capacity and maximum ventilation volume of the 2 groups were significantly increased compared with those before treatment, and the values of pulmonary function indexes in the observation group at the same time point were better than those in the control group ( P < .05). Before treatment, the inflammatory factors, PaO 2 /FiO 2 , and RR in the 2 groups were compared ( P > .05). On the 5th and 7th day after treatment, the tumor necrosis factor-α, interleukin-1β, RR, and intercellular adhesion molecule-1 (ICAM-1) in the 2 groups were significantly decreased compared with those before treatment, while the NOD-like receptors (NLR) family pyrin domain containing 6 (NLRP6) and PaO 2 /FiO 2 were significantly increased. At the same time, the values of tumor necrosis factor-α, interleukin-1β, ICAM-1, and RR after decreased and NLRP6 and PaO 2 /FiO 2 after increased in the observation group were better than those in the control group ( P < .05). Conclusion: Sivelestat sodium can improve lung function, correct PaO 2 /FiO 2 , and promote rehabilitation in patients with acute lung injury, which may be related to the regulation of NLRP6, ICAM-1, and other inflammatory factors.