大剂量乌司他丁治疗感染性休克临床观察

The clinical observation of high-dose ulinastatin in septic shock

目的观察大剂量乌司他丁治疗感染性休克的临床效果。方法将感染性休克患者36例随机分为治疗组和对照组,各18例。治疗组在常规治疗基础上首先应用乌司他丁20万U加入生理盐水30ml中静脉推注,再用乌司他丁100万U持续微量泵入,速度5万U/h,连用7d;对照组给予常规治疗。比较2组患者治疗后多种炎性反应指标和多器官功能障碍综合征(MODS)的发生率。结果 2组患者治疗后3d体温、呼吸、心率、白细胞计数、超敏C反应蛋白水平均得到改善(P<0.05);治疗组治疗后3d呼吸、心率、白细胞计数、超敏C反应蛋白水平均优于对照组,差异均有统计学意义(P<0.05);治疗组MODS发生率为33.3%低于对照组的61.1%,差异有统计学意义(P<0.05)。结论大剂量乌司他丁能有效降低感染性休克患者的炎性反应程度,降低MODS的发生率,值得推广应用。

Objective To explore the clinical effect of high-dose ulinastatin in septic shock.Methods 36 cases patients with septic shock were randomly divided into treatment group and control group,each of 18 cases.On the basis of conventional therapy,treatment group were given ulinastatin 200 000U＋normal saline 30ml intravenous injection,and then ulinastatin 1 million U continuous micro-pump pump,speed of 50 000U/h,conjunction 7d.Control group received conventional therapy.After treatment,compared a variety of indicators of inflammation and multiple organ dysfunction syndrome（MODS） incidence.Results After treatment 3d body temperature,respiration,heart rate,white blood cell count,high-sensitivity C-reactive protein and other inflammatory indicators of two groups were improved（P〈0.05）;After treatment 3d,breathing,heart rate,white blood cell count,high sensitivity C-reactive protein of treatment group were better than those of control group,the difference were statistically significant（P〈0.05）;The MODS incidence of treatment group（33.3%） was lower than that of control group（61.1%）,the difference was statistically significant（P〈0.05）.Conclusion High-dose ulinastatin can effectively reduce inflammatory response in patients with septic shock and the incidence of MODS.