摘要
目的观察乌司他丁(UTI)对烧伤“休克心”的防治作用,探讨其可能的机制。方法选择笔者单位收治的伤后24h内人院、烧伤面积>50%TBSA的34例特重度烧伤患者,分为烧伤组和UTI治疗组,每组17例。两组患者均进行常规治疗,且UTI治疗组患者入院后立即给予UTI 10万U静脉滴注,3次/d,连续7d。于两组患者伤后2、4、7d采血,检测其血浆中性粒细胞弹性蛋白酶(PMN elastase)、心肌肌钙蛋白I(cTnI)含量和心肌型肌酸激酶同工酶(CK-MB)活性,以公认的各指标正常值作参考,并对3项指标进行相关性分析。结果(1)伤后2、4、7d,两组患者血浆PMN elastase及cTnI含量均显著高于正常值(P<0.01);UTI治疗组与烧伤组比较,两指标偏低。(2)与正常值比较,伤后2、4、7d烧伤组患者CK-MB活性明显升高(P<0.01),第4天达高峰;UTI治疗组伤后2、4d CK-MB活性明显高于正常值(P<0.05或0.01),但与烧伤组比较升幅较小,第7天降至正常值水平(P>0.05)。(3)34例烧伤患者PMN elastase、cTnI含量及CK-MB活性三者间均呈现显著正相关,前两者的相关系数为0.904,后两者的相关系数为0.922,PMN elastase含量与CK-MB活性的相关系数为0.829(均为P<0.01)。结论UTI能够显著减轻严重烧伤患者心肌损害的程度,有效抑制PMN elastase的过度释放。
Objective To investigate the effect of Ulinastatin on the management of early myocardial injury and its mechanisms. Methods Thirty-four severe burn patients with TBSA exceeding 50% were admitted into our hospital within 24hrs after burns, and they were divided into burn group( n = 17) and ulinastatin-treated group ( n = 17, UTI group). All patients received conventional treatment. The patients in UTI group were given 100,000 U ulinastatin intravenously immediately after admission, 3 times a day for a week. The plasma content of troponin I(cTnI) , creatine kinase (CK-MB) and PMN elastase were determined on 2, 4 and 7 postburn days(PBD) , and the correlate relationship among these three indices were analyzed. Results ( 1 ) The plasma content of cTnI and PMN elastase at 2, 4, 7 PBDs were significantly higher than that of normal value ( P 〈 0.01 ) , but they were obviously lower in UTI group than that in burn group . (2) Compared with normal value, the plasma content of CK-MB in burn group was increased significantly on 2, 4 and7 PBDs ( P 〈0.01), and it reached the peak on 4 PBD. Though it was obviously higher in UTS group on 2 and 4 PBDs compared with the normal value, but it was lower than that in .burn group ( P 〈 0.05 or 0.01 ) , and it returned to normal value on 7 PBD. (3) There exhibited positive correlation among the PMN elastase content, cTnI content and CK-MB activity of the 34 patients. The correlation index of PMN elastase content and cTnI content was 0. 904, while that between cTnI content and CK-MB activity was 0. 922, and that between PMN elastase content and CK-MB activity was 0. 829( P 〈 0.01 ). Conclusion Ulinastatin is beneficial in alleviating myocardial injury after severe burns, and it reduces the release of PMN elastase.
出处
《中华烧伤杂志》
CAS
CSCD
北大核心
2006年第3期180-183,共4页
Chinese Journal of Burns
基金
国家杰出青年科学基金(30125040)
全军医学科学技术研究"十五"计划指令性课题资助项目(01L066)
全军首批临床高新技术重大资助项目(2002)