大剂量乌司他丁治疗全身炎症反应综合征及合并多器官功能障碍综合征的临床研究

The research of the clinical effect for high-dose ulinastatin small on the SIRS and patients with MODS

目的 研究大剂量乌司他丁对全身炎症反应综合征（SIRS）及合并多器官功能碍综合征（MODS）的临床效果。方法 选择120例ICU患者,随机分为两组,各60例,对照组采用常规治疗,观察组在对照组基础上于治疗开始后12 h内开始静脉注射大剂量乌司他丁,观察两组治疗后细胞因子含量以及住院时间、病死率和治疗前后APACHE Ⅱ评分。结果 两组治疗前肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）和APACHE Ⅱ评分差异无统计学意义;治疗后48 h、72 h,两组TNF-α、IL-6、IL-8均较治疗前下降,且观察组下降幅度明显大于对照组（t=8.46、8.72、8.68、10.38、7.83、9.26,均P〈0.05）,治疗后观察组APACHE Ⅱ评分、病死率、平均住院时间均明显低于对照组（t=9.58、χ2=10.28、t=9.17,均P〈0.05）。结论 大剂量乌司他丁对炎性细胞因子有明显的抑制作用,可降低ICU高危患者的APACHE Ⅱ评分和病死率,缩短患者的治疗时间。

Objective To study the clinical effect of large dose ulinastatin on patients combined SIRS and MODS.Methods 120 patients in ICU were randomly divided into two groups,each 60 cases,the control group using conventional standard treatment,the observation group in the control group on the basis of the 12h after the operation started on intravenous injection of large dose ulinastatin,observe two groups of patients after treatment with cytokine content and duration of hospital stay,mortality rate and APACHE Ⅱ score after treatment.Results The two groups before treatment TNFα,IL-6,IL-8 and APACHE Ⅱ score difference is not big,after treatment,48h,72h,two groups of patients with TNFα,IL-6,IL-8 were decreased,and the observation group decreased greater than the control group（t=8.46,8.72,8.68,10.38,7.83,9.26,all P〈0.05）,after treatment the observation group APACHE Ⅱ score,mortality,average time of hospitalization were significantly lower than those of the control group,there was statistical significance（t=9.58, χ2=10.28,t=9.17,all P〈0.05）. Conclusion High dose ulinastatin on inflammatory cytokines have obvious inhibition effect,can reduce the surgical risk in patients with APACHE Ⅱscore and mortality,shorten the treatment time of patients.