不同剂量乌司他丁治疗感染性休克的临床研究

Clinical Efficacy of Different Doses of Ulinastatin for the Treatment of Patients with Septic Shock

【目的】研究不同剂量乌司他丁（UTI）对感染性休克患者的临床疗效。【方法】将60例感染性休克患者随机分为三组，每组20例。对照组（I组）予常规治疗；II组和Ⅲ组在常规治疗基础上分别加用UTI100kU和200kU静脉滴注，12h1次；均连用7d。检测三组患者治疗前及治疗1周后血浆降钙素原（PCT）、肿瘤坏死因子一cdTNF-a）、白介素一6（IL一6）的水平，记录休克恢复时间、平均住院天数和28d病死率，比较三组患者各指标间的差异。【结果】治疗前三组患者血浆各指标间差异无统计意义（P〉0．05）。治疗1周后Ⅱ、Ⅲ组患者血浆PCT、TNF_口、IL一6的水平，休克恢复时间、平均住院天数和28d病死率明显低于I组（P〈0．01）；Ⅲ组患者各指标明显低于Ⅱ组（P〈O．01）。【结论】UTI能有效降低感染性休克患者血浆PCT水平，抑制过度的炎症反应，具有抗休克、降低平均住院天数和病死率的作用，且呈明显的量效关系。

[Objective] To study the clinical efficacy of different doses of ulinastatin for the treatment of patients with septic shock. [Methods] Sixty patients with septic shock were randomly divided into 3 groups with 20 cases in each group. The control group（Group I ） received routine treatment. On the basis of the rou tine treatment, Group 11 additionally received intravenous injection of ulinastatin 100 kU once every 12 hours for 7 days based on the routirie treatment, while Group Ⅲ additionally received ulinastatin 200 kU once every 12 hours for 7 days. Plasma procalcitonin （ PCT）, tumor necrosis factora （TNFa） and interleukin6 （IL6） were measured before and a week after treatment. The time of shock recovery, the average hospitalization days and 28day mortality rate were recorded. [Results]There was no significant difference in all indicators among 3 groups before treatment（ P ~0.05）. After one week of the treatment, plasma levels of PCT, TNFa and IL 6, the time of shock recovery, average hospitalization days, 28day mortality in Group ]] and group I]] were significantly lower than those in the Group I （ P d0.01）, while those in Group [II were obviously lower than Group II （ P d0.01）. [Conclusion]Ulinastatin can effectively reduce plasma PCT, inhibit inflammatory re sponse in patients with septic shock, so it can resist shock and reduce the average hospitalization days and mor tality rate with obvious doseeffect relationship.