蛋白酶抑制剂对老年泌尿系重症脓毒症患者的细胞因子的影响

目的通过观察患者细胞因子的变化评价蛋白酶抑制剂对老年泌尿系重症脓毒症患者的疗效。方法66例老年泌尿系重症脓毒症患者随机均分为乌司他丁组(U组)与对照组(C组),在相同治疗基础上,U组给予乌司他丁针剂10万U静脉注射,q6h,持续6d。C组则给予等量生理盐水作为安慰剂对照。在治疗前、治疗后24、48、120h进行APACHEⅡ评分,测定血清TNF-α、IL-6和IL-8的浓度。结果治疗前两组患者APACHEⅡ评分值相似("P>0.05"),治疗后结果显示,U组患者的TNF-α的血清浓度在24h内即明显下降,与C组相比,差异有显著性("P<0.05");U组患者IL-6、IL-8的浓度在治疗后也较C组下降明显,并在治疗后120h两组差异有显著性("P<0.05");结论乌司他丁能够改善老年泌尿系重症脓毒症患者的病情,可能与其降低老年泌尿系重症感染患者血中促炎因子TNF-α、IL-6、IL-8的水平有关。

Objective To evaluate the efficacy of ulinastatin in old patients with severe Urological sepsis. Methods Sixty-six old patients were randomly divided into ulinastatin treatment group （group U） and control group （group C）. Patients in group U received ulinastatin 100000 unit s intravenous once per 6 hours,while those in group C received equal quantity of normal saline as placebo. Before treatment and at 24 th ,48 th ,120 th hour after start of treatment ,The level of the blood concentration of tumor necrosis factor-alpha（TNF- α ）, interleukin-6, interleukin-8 （IL-8） in serum were assayed. Results In comparision with control group ,the concentration of TNF-in group U patients decreased more markedly than that in group C of 24 to 48 hours after treatment as well as IL-6 and IL- 8. Conclusions Ulinastatin improves condition of old patients with severe Urological sepsis. Ulinastatin can decrease the blood concent ration of TNF-and IL-6 and IL-8 in old patients with severe sepsis.