目的 观察卡托普利治疗重症急性胰腺炎肺损伤的临床疗效。方法 选取2014年4月-2016年3月鄂东医疗集团黄石市中心医院收治的重症急性胰腺炎肺损伤患者82例，随机分为对照组和治疗组，每组各41例。对照组给予常规治疗，包括禁饮禁食，补液，维持水、电解质及酸碱平衡，持续胃肠减压，抑制胰酶分泌，防治胰腺继发感染，静脉营养支持。治疗组在对照组基础上静脉滴注卡托普利注射液，50 mg加入到0.9%氯化钠溶液100 mL中，1次/d。两组患者均连续治疗7 d。观察两组的临床疗效，比较两组肺功能指标、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）。结果 治疗后，对照组和治疗组的总有效率分别为80.5%、92.7%，两组比较差异有统计学意义（P<0.05）。治疗后，两组血氧分压（PaO₂）和PaO₂/吸入氧浓度（FiO₂）均显著升高，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组这些观察指标的升高程度明显优于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组IL-6和TNF-α均显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组这些观察指标的下降程度明显优于对照组，两组比较差异具有统计学意义（P<0.05）。结论 卡托普利治疗重症急性胰腺炎肺损伤具有较好的临床疗效，能改善肺功能，降低炎性因子，安全性较好，具有一定的临床推广应用价值。

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.