乌司他丁对严重蝮蛇咬伤器官损害及全身炎症反应的抑制作用

Effect of ulinastatin on important organs and systemic inflammatory response after serious snake bite

目的 探讨乌司他丁（ulinastatin,UTI）对蝮蛇咬伤后的重要器官功能保护及全身炎症反应的抑制作用.方法 选择42例严重蝮蛇咬伤患者,随机分为对照组和UTI治疗组.对照组常规给予抗蝮蛇毒血清和季德胜蛇药片治疗,UTI组则在对照组的治疗基础上加用UTI治疗,连续3 d.各组分别于治疗前及治疗1、2、3 d测定动脉血气分析、血常规及临床生化指标.结果 与对照组比较,UTI治疗组外周血中C反应蛋白、白细胞计数、心率、呼吸频率及PaCO2显著改善（P〈0.05或P〈0.01）;UTI治疗组治疗3 d心肌酶学、肝功能及肾功能指标显著改善,其中AST、ALT、BUN、Cr、LDH及CK与治疗前比较差异有统计学意义（P〈0.05或P〈0.01）.UTI治疗组治疗3 d CK、Cr、BUN、ALT、AST、LDH与对照组比较差异有统计学意义（P〈0.05或 P〈0.01）,而CK-MB两组比较差异无统计学意义（P〉0.05）.结论 UTI能有效降低蝮蛇蛇毒导致的器官功能损害,抑制全身炎症反应综合征.

Objective To explore the effect of ulinastatin （UTI） on important organs and systemic inflammatory response after severe snake bite. Methods 42 cases with serious snake bites were randomly divided into control group and the UTI group. The control group was given conventional anti - viper snake serum and Jidesheng tablets, the UTI group was given UTI treatment for 3 days on the basis of the control group. Arterial blood gas analysis and full blood count and clinical biochemical markers were detected before treatment and on 1st, 2nd, 3rd after admission. Results Compared with control group, C reactive protein and WBC in peripheral blood, heart rate and respiratory rate and PaCO2 changed significantly （P〈 0. 05 or P 〈 0. 01 ）. In UTI group, serum creatine kinase, liver function and renal function markers improved significantly after 3 - day treatment, especially AST, ALT, BUN, Cr, LDH and CK markers （ P 〈 0. 05 or P 〈 0. 01 ）. There were statistical significance in CK, Cr, BUN, ALT, AST, LDH between the UTI group and control group after 3 -day treatment（P 〈0. 05 or P 〈 0. O1 ）, expect CK - MB （ P 〉 0.05 ）. Conclusion UTI can effectively reduce the damage of organ function and inhibite systemic inflammatory response syndrome.