Abstract:Objective To investigate the clinical efficacy of glucocorticoid combined with ulinastatin in patients with early acute lung injury（ALI）after trauma. Methods A total of 100 patients with early ALI after trauma who admitted to Shengjing Hospital of China Medical University from June 2022 to December 2024 were selected. They were divided into a control group（n = 50，treated with ulinastatin）and an observation group［n = 50，treated with glucocorticoids（hydroprednisone injection） on the basis of the control group］ using the random number table method. The hospitalization indicators，serum cytokine levels［interleukin（IL）-6，IL-10］，respiratory function［extravascular lung water index（ELWI），arterial partial pressure of oxygen（PaO2），fraction of inspired oxygen（FiO2）and oxygenation index（PaO2/FiO2）］，and incidence of complications were compared between the two groups. Results The days in ICU and the hospital stay in the observation group were shorter than those in the control group，and the incidence of acute respiratory distress syndrome（ARDS）was lower in the observation group than that in the control group（10.00% vs28.00%，χ2=5.263，P<0.05）. After 7 days of treatment，the levels of IL-6 and ELWI in the observation group were lower than those in the control group，while the levels of IL-10 and oxygenation index were higher in the observation group than those in the control group（P < 0.05）. The incidence of complications in the observation group was lower than that in the control group（8.00% vs 26.00%，χ2=5.741，P<0.05）. Conclusion The combination of glucocorticoids and ulinastatin can regulate the balance of IL-6/IL-10，increase oxygenation index，and improve the prognosis in early post-traumatic ALI patients.