乌司他丁对术后老年危重患者血清超敏C-反应蛋白水平及预后影响的临床观察

Clinical study on ulinastatin used for the treatment of critically ill elderly patients after operation and its effect on serum hypersensetive-C reaction protein(hs-CRP) levels and prognosis

目的:观察乌司他丁对术后老年危重患者超敏C反应蛋白(hS-CRP)水平及预后的影响,探讨其改善术后老年患者全身炎性反应综合征的作用。方法:选择符合入选标准的术后老年危重患者共95例,随机分为乌司他丁治疗组(U组)48例和对照组(C组)47例。U组患者在接受常规治疗的同时术后6 h内开始静脉注射乌司他丁,每次30万单位,q6 h,连续7 d。C组患者接受常规治疗+安慰剂(生理盐水)。2组患者分别于治疗前及治疗后第3,7天做hS-CRP检测,并同时进行APA-CHEII评分,观察并发症发生率及死亡率。结果:2组患者治疗后血清hs-CRP浓度、APACHEⅡ评分分别与治疗前比较,均明显下降,差异有统计学意义(P<0.05);U组治疗3 d后血清hs-CRP浓度、APACHEⅡ评分与C组治疗3 d后比较下降更加显著(P<0.05),并发症发生率无差异;治疗7 d后U组血清hs-CRP浓度、APACHEⅡ评分与C组比较,U组改善优于C组(P<0.01),2组并发症发生率及死亡率比较,U组明显低于C组(P<0.05)。结论:乌司他丁可抑制外科术后老年危重患者hS-CRP表达、降低患者APACHEⅡ评分,从而改善患者预后。

OBJECTIVE To observe the clinical efficiency of ulinastatin on treating critically ill elderly patients after operation and its effect on serum hypersensetive C reactive protie（hs-CRP） levels and prognosis,and to evaluate the therapeutic effect.METHODS Ninty-five critically ill elderly patients after operation according with the criteria were randomly divided into ulinastatin treatment group（group U） and control group（group C）.Patients in the group U received ulinastatin 300 000 units intravenous quaque sexta hora in 6 hours after operation,while those in the group C received equal quantity of normal saline as placebo.At the time of admission and 3,7 days after initiation of treatment,serum levels of hs-CRP were measured and APACHE Ⅱ scores were made.The outcomes were compared between these two groups.RESULTS Plasma concentrations of hs-CRP and APACHEⅡ scores in group U decreased more obviously than those in group C.There were significant differences between U group and C group of the incidence of complications and the mortality rate.CONCLUSION Ulinastatin can decrease the blood concentration of hs-CRP in critically ill elderly patients after operation.It can reduce APACHE Ⅱ scores and improve prognosis.