乌司他丁对重型颅脑损伤患者脑氧代谢、炎性因子及肾功能的影响

Influence of Ulinastatin on the Cerebral Oxygen Metabolism Inflammatory Factors and Renal Function of Patients with Severe Craniocerebral Injury

目的:探讨乌司他丁对重型颅脑损伤(SCCI)对患者脑氧代谢、炎性因子及肾功能的影响。方法:将98例SCCI患者随机分为对照组和观察组,每组患者49例。对照组患者给予常规对症支持治疗,观察组患者在此基础上给予乌司他丁滴注治疗。比较两组治疗前及治疗第3 d、7 d的脑氧代谢(SjvO_2、CaO_2、A-vDO_2和CERO_2)、炎性因子(TNF-α、IL-6和IL-10)及肾功能(BUN和Cr)的变化。结果:治疗前,两组患者的SjvO_2、CaO_2、A-vDO_2、CERO_2、TNF-α、IL-6、IL-10、BUN和Cr水平比较差异均无统计学意义(P>0.05);治疗3 d、7 d,观察组患者的SjvO_2、CaO_2和IL-10水平均显著高于对照组,A-vDO_2、CERO_2、TNF-α、IL-6、BUN和Cr水平均显著低于对照组,差异显著具统计学意义(P<0.05)。结论:乌司他丁治疗SCCI可有效改善患者的脑氧代谢、肾功能,减轻炎症反应。

Objective： To investigate the influence of ulinastatin on the cerebral oxygen metabolism inflammatory factors and renal function of patients with severe craniocerebral injury. Methods： 98 cases of SCCI patients were randomly divided into the control group （n=49） and the observation group （n=49）. The control group was given routine symptomatic treatment, while the observation group was treated with ulinastatin on the basis of control group. The cerebral oxygen metabolism （SjvO2, CaO2, A-vDO2 and CERO2）, inflam- matory factors （TNF-α, IL-6 and IL-10） and renal function （BUN and Cr） were compared between the two groups before and at 3 d, 7 d after treatment. Results： No significant difference of SjvO2, CaO2, A-vDO2, CERO2, TNF-α, IL-6, IL-10, BUN and Cr levels between the two groups before treatment （P〉0.05）. At 3d, 7d after treatment, the levels of SjvO2, CaO2 and IL-10 in the observation group were signif- icantly higher than those in the control group, the levels of A-vDO2, CERO2, TNF-α, IL-6, BUN and Cr were significantly lower than those in the control group（P〈0.05）. Conclusion： Ulinastatin could effectively improve the cerebral oxygen metabolism and renal function, relieve the inflammatory response in the treatment of SCCI.