乌司他丁对脓毒症患者器官功能的保护作用

摘要

Objective:To investigate the protective mechanism and efficacy of ulinastatin (UTI) on level of C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α) and heart kidney liver organ function in patients with sepsis.Method:68 patients with sepsis were divided into UTI group and routine group according to the random double blind method. The routine group was given routine treatment, included: early recovery, monitoring lactate guiding rehydration, antibiotics application, mechanical ventilation, blood purification; on the basis of conventional treatment,the UTI group was given 300 000 units UTI, and soluble in 0.9% saline 50 mL, intravenous drip, 2 times / day, each 1 h drip off, for 7 days. TNF-α, IL-6 CRP and other heart and kidney biochemical indexes were determined before the treatment and 8 days after the treatment of the two groups.Result: After treatment, CRP, TNF-α, IL-6 levels of two groups were compared with before treatment, the differences had statistical significance (P<0.05), while the UTI group had more significant difference (P<0.05). ALT, AST, BUN, Cr and UA of two groups were significantly lower compared with before treatment, the differences had statistical significance (P<0.05), while the UTI group decreased significantly (P<0.05); LDH, CK and CK - MB were significantly lower of two groups compared with before treatment, and the differences were statistically significant (P<0.05), while the UTI group decreased significantly (P<0.05).Conclusion:UTI has beneficial effects on the protection of liver kidney heart in patients with sepsis.%目的：探讨乌司他丁（UTI）对脓毒症患者C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）水平的影响及心肝肾的保护作用。方法：将68例脓毒症患者按随机双盲法分为UTI组和常规组。常规组进行常规治疗，包括：早期复苏、监测乳酸指导补液、抗菌药物应用、机械通气、血液净化；UTI组在常规治疗基础上，加用UTI 30万单位，溶于0.9%生理盐水50 mL，静脉滴注，2次/d，每次1 h滴完，共7 d。于治疗前和治疗后第8天测定血浆CRP水平、TNF-α和IL-6水平及心肝肾生化指标。结果：治疗后，两组CRP、TNF-α、IL-6水平与治疗前比较差异均有统计学意义（P<0.05），而UTI组差异更为明显（P<0.05）；两组血浆丙氨酸转氨酶（ALT）、天冬氨酸转氨酸转氨酶（AST）、肌酐（Cr）、尿素（BUN）、尿酸（UA）较治疗前均明显降低，差异均有统计学意义（P<0.05），而UTI组降低更为显著（P<0.05）；两组血浆乳酸脱氢酶（LDH）、肌酸激酶（CK）及其同工酶（CK-MB）均较治疗前均明显降低，差异均有统计学意义（P<0.05），而UTI组降低更为显著（P<0.05）。结论：乌司他丁显著降低CRP、TNF-α、IL-6水平，对脓毒症患者的心肝肾功能有较好的保护作用。