OBJECTIVE: To probe into the clinical efficacy of ulinastatin combined with alprostadil in the adjuvant treatment of acute respiratory distress syndrome（ ARDS） induced by sepsis and its effects on prognosis. METHODS:Totally 79 patients with ARDS induced by sepsis admitted into Mianyang Central Hospital from Feb. 2018 to Mar.2020 were extracted to be divided into the observation group（ n = 40） and the control group（ n = 39） via the random number table. The control group was treated with ulinastatin for 7 d

while the observation group received ulinastatin combined with alprostadil for 7 d. The duration of mechanical ventilation

length of stay

acute physiology and chronic health evaluationⅡ（ APACHEⅡ） score and sequential organ faliure assessment（ SOFA） score

inflammatory factors

coagulation parameters

extravascular lung water index（ EVLWI） and pulmonary vascular permeability index（ PVPI）

adverse drug reactions

and 28-d survival of two groups were compared. RESULTS: The duration of mechanical ventilation and length of stay in the observation group were significantly shorter than those in the control group

and the APACHEⅡ score and SOFA score on the 7 th d of treatment were significantly lower than those in the control group

with statistically significant differences（ P < 0. 05）. Arterial partial pressure of carbon dioxide（ PaCO2）

C-reactive protein（ CRP）

tumor necrosis factor-α（ TNF-α）

D-dimer

fibrinogen（ Fib）

EVLWI and PVPI in two groups decreased significantly on the 3 rd and 7 th of treatment

and the arterial partial pressure of oxygen（ PaO2） and oxygenation index（ PaO2/Fi O2） increased

the differences were statistically significant compared with those before treatment（ P < 0. 05）. The PaO2

PaO2/Fi O2 of the observation group were significantly higher than those of the control group on the 3 rd and 7 th day of treatment

PaCO2

CRP

TNF-α

D-dimer

Fib

EVLWI and PVPI were significantly lower than those of the control group

the differences were statistically significant（ P < 0. 05）. The survival of patients in the observation group within 28 d of length of stay was 82. 50%（ 33/40）

significantly higher than58. 97%（ 23/39） in the control group

the difference was statistically significant（ Log-Rank test

χ2= 5. 771

P =0. 016）. CONCLUSIONS: Ulinastatin combined with alprostadil in the adjuvant treatment of ARDS induced by sepsis can effectively inhibit the inflammatory response

reduce blood viscosity and pulmonary vascular permeability

correct hypoxemia

shorten the duration of mechanical ventilation and length of stay

and improve the prognosis of patients.