目的 研究山莨菪碱联合乌司他丁治疗急性呼吸窘迫综合征的临床效果。方法 选取2015年1月-2016年12月杨凌示范区医院重症监护室收治的急性呼吸窘迫综合征患者206例，按照住院顺序分为对照组和治疗组，每组各103例。对照组患者静脉滴注乌司他丁注射液20万单位加到5%葡萄糖500 mL，2次/d。治疗组在对照组治疗基础上静脉滴注盐酸消旋山莨菪碱注射液，首次静脉注射0.2 mg/kg，必要时每隔30分钟重复给药。两组均连续治疗14 d。观察两组治疗前后临床结局、一般临床指标、动脉血氧分压（pO₂）、动脉二氧化碳分压（pCO₂）、（pO₂/FiO₂）、白细胞计数（WBC）、C反应蛋白（CRP）、降钙素原（PCT）、白细胞介素-6（IL-6）的变化情况。结果 治疗期间，对照组和治疗组的死亡率分别为37.9%、20.4%，两组比较差异有统计学意义（P<0.05）。治疗组患者机械通气时间、ICU住院时间均少于对照组，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者呼吸频率、心率、APACHEⅡ评分、MODS评分、pCO₂、WBC、CRP、PCT、IL-6显著降低，pO₂、pO₂/FiO₂显著升高，同组治疗前后比较差异具有统计学意义（P<0.05）；且治疗后治疗组呼吸频率、心率、APACHEⅡ评分、MODS评分、pCO₂、WBC、CRP、PCT、IL-6低于对照组，pO₂、pO₂/FiO₂高于对照组，两组比较差异有统计学意义（P<0.05）。结论 山莨菪碱联合乌司他丁治疗急性呼吸窘迫综合征具有较好的临床疗效，可有效改善肺氧合功能，降低炎症因子水平，减少机械通气时间和住院时间，降低患者死亡率，具有一定的临床推广应用价值。

Objective To research the clinical effects of anisodamine combined with ulinastatin in treatment of acute respiratory distress syndrome. Methods Patients (206 cases) with acute respiratory distress syndrome in Yangling Demonstration Zone Hospital from January 2015 to December 2016 were divided into control (103 cases) and treatment (103 cases) groups according to different hospital orders. Patients in the control group were iv administered with Ulinastatin Injection, 2×10⁵ U added into 5% glucose 500 mL, twice daily. Patients in the treatment group were iv administered with Raceanisodamine Hydrochloride Injection on the basis of the control group, and first intravenous injection was 0.2mg/kg, repeated every 30 min if necessary. Patients in two groups were treated for 14 d. After treatment, the clinical outcomes, general clinical indicators, pO₂, pCO₂, pO₂/FiO₂, WBC, CRP, PCT, and IL-6 in two groups before and after treatment were observed. Results After treatment, the mortality rate of control and treatment group was 37.9% and 20.4%, respectively, and there were differences between two groups (P<0.05). After treatment, mechanical ventilation time and ICU hospital time in the treatment group were shorter than those in the control group, and there were differences between two groups (P<0.05). After treatment, respiratory rate, heart rate, APACHEⅡ score, MODS score, pCO₂, WBC, CRP, PCT, and IL-6 in two groups were significantly decreased, but pO₂, pO₂/FiO₂ were significantly increased, and there were differences between two groups (P<0.05). After treatment, respiratory rate, heart rate, APACHEⅡ score, MODS score, pCO₂, WBC, CRP, PCT, and IL-6 were lower than those in the control group, but pO₂, pO₂/FiO₂ were higher than those in the control group, and there were differences between two groups (P<0.05). Conclusion Anisodamine combined with ulinastatin has clinical curative effect in treatment of acute respiratory distress syndrome, and can effectively improve lung oxygenation function, reduce inflammation factors, shorten mechanical ventilation time and hospitalization time, and reduce patient mortality, which has a certain clinical application value.