Objective To investigate the effect of ulinastatin on inflammatory response,immune status and intestinal barrier function in patients with severe abdominal infection. Methods Selected 76 patients with severe abdominal infection admitted to Department of General Surgery,Handan Central Hospital from October 2013 to October 2016 as the research ob-ject. Random number table method was used to divide the patients into observation group and control group,38 cases in each group. According to guidelines for routine treatment,the observation group of patients on the basis of routine treatment, also given 200,000 units of ulinastatin 8h / time,two groups of patients was treated for 7 d. The levels of CD3 +,CD4 +,plasma endotoxin,intestinal fatty acid binding protein,D lactate, diamine oxidase and APACHEⅡ scores of IgA, IgM, IgG and T lymphocyte subsets in two groups before and after treatment were compared. Patient's ICU hospital stay and 28 day survival were compared. Results The levels of CD3 +,CD4 +,plasma endotoxin,intestinal fatty acid binding protein,D lactate,di-amine oxidase and APACHEⅡscores of IgA,IgM,IgG and T lymphocyte subsets in the two groups before treatment were not significantly different (t/P=0.166 / 0.869, t/P=0.215 / 0.830, t/P=0.063 / 0.950, t/P=0.557 / 0.580, t/P=0.644 / 0.644,t/P=0.369 / 0.713,t/P=0.058/0.954,t/P=0.142 / 0.888). After 7 days of treatment,the above in-dexes in both groups decreased to some extent compared with before treatment. After treatment, the above indexes decreased more significantly in observation group (t/P =3.676/0.000, t/P =3.614/0.001, t/P =4.372/0.000, t/P =16.138/0.000,t/P=35.580/0.000,t/P=10.206/0.000,t/P=4.683/0.000,t/P=5.471/0.000,t/P=9.315/0.000,t/P=6.435/0.000). Mortality was not significant different(χ2=0.395,P=0.724). Conclusion Ulinastatin can effectively re-duce inflammation in patients with severe intraperitoneal infection, improve immune function, reduce inflammatory injury of organ,play a role in the protection of intestinal barrier function.%目的 观察乌司他丁对严重腹腔感染(sIAI)患者免疫状态及肠屏障功能的影响.方法 选择2013年10月-2016年10月河北省邯郸市中心医院普外科收治的严重腹腔感染患者76例作为研究对象,采用随机数字表法分为观察组和对照组各38例,2组患者均按照相关指南进行常规治疗,观察组患者在常规治疗的基础上给予乌司他丁20万IU静脉注射,次/8 h,2组患者均治疗7 d.对比2组患者治疗前后的IgA、IgM、IgG、T淋巴亚群CD3 +、CD4 +、血浆内毒素、D-乳酸、肠脂肪酸结合蛋白、二胺氧化酶水平及APACHEⅡ评分变化情况,同时观察2组患者的ICU住院时间及28 d生存情况.结果 治疗前2组患者的IgA、IgM、IgG、T淋巴亚群CD3 +、CD4 +、血浆内毒素、D-乳酸、肠脂肪酸结合蛋白、二胺氧化酶水平及APACHEⅡ评分比较差异无统计学意义(P>0.05);治疗7 d后,2组患者的上述指标均较治疗前不同程度下降(P<0.01),治疗7天后组间比较,观察组患者上述指标下降更显著(t/P值分别为:3.676/0.000、3.614/0.001、4.372/0.000、16.138/0.000、35.580/0.000、10.206/0.000、4.683/0.000、5.471/0.000、9.315/0.000、6.435/0.000);治疗7 d后,观察组入住ICU时间明显短于对照组(P<0.05).2组患者28 d病死率比较差异无统计学意义(χ2=0.395,P=0.724).结论 乌司他丁可有效减轻严重腹腔感染患者炎性反应,改善患者免疫功能,减少脏器炎性损伤打击,保护肠屏障功能.
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