乌司他丁对感染性休克患者血清白介素-6、10和降钙素原水平的影响

Effect of Ulinastatin on Serum Interleukin-6 and 10(IL-6 and 10) and Procalcitonin Levels of Patients with Septic Shock

目的:探讨乌司他丁对感染性休克患者血清白细胞介素-6(IL-6)、白细胞介素-10(IL-10)和降钙素原(PCT)水平的影响及疗效。方法:64例感染性休克患者随机分为观察组和对照组各32例。两组患者均予以补液扩容、抗感染及维持水电解质酸碱平衡等治疗,必要时行机械通气及使用血管活性药物治疗。观察组在此基础上加用乌司他丁20万U加入0.9%氯化钠注射液100 ml中静滴,q12h,对照组予等量0.9%氯化钠注射液静脉,两组疗程均为1周。比较两组患者治疗前后血清IL-6、IL-10和PCT水平的变化,观察治疗后多器官功能障碍综合征(MODS)的发生率、病死率及药物不良反应。结果:治疗1周后,两组患者血清IL-6和PCT水平均较治疗前下降,血清IL-10水平均较治疗前上升(P<0.05或0.01),且观察组下降或上升值明显大于对照组(P<0.05)。观察组患者MODS发生率明显低于对照组(P<0.05)。两组患者病死率和药物不良反应发生率比较差异无统计学意义(P>0.05),治疗期间未发生严重药物不良反应。结论:基础治疗同时加用乌司他丁治疗感染性休克疗效显著,安全性较佳,能明显减少MODS发生率,其治疗效果与抑制血清IL-6和PCT释放和促进IL-10释放密切相关。

Objective：To discuss the influence of ulinastatin on serum interleukin-6 （IL-6） and interleukin-10 （ IL-10 ） and procalcitonin （PCT） levels of patients with septic shock. Methods ：4 cases of patients with septic shock were selected and divided into the observation group and controlled group at random. The patients in both groups were given fluid expansion, anti-infection, maintenance of water and electrolyte acid-base balance and other medical treatment. The mechanical ventilation and vasoactive agent were used when necessary. The patients in observation was additionally given 200 000 U Ulinastatin, which was added into 100ml 0.9% sodium chloride injection by intravenous drip tor 12 hours. The patients in the controlled group were given 0.9% sodium chloride injection by intravenous drip with the same quantity as that in the ohservation group. The coupes of treatment in the two groups were 1 week. The changes of serum IL-6, IL-10 and PCT levels of the two groups were compared before and after the medical treatment, and the occurrence rate of their multiple organ dysfunction syndrome （MODS）, case fatality rate and drug adverse reaction （DAR） were observed ＇after the medical treatment. Results：After l week＇s medical treatment, serum IL-6 and PCT levels of the patients in the two groups declined more obviously than before, while serum IL-10 level rose more obviously than before （ P 〈 0.05 or 0.01 ） , and the declining or rising rate of the patients in the observation group were much higher than those in the controlled group （ P 〈 0.05 ）. The MODS occurrence rate of the patients in the ohservation group was much lower than that in the controlled group （P 〈0.05 ）. After comparing the case fatality rate and DAR oceurrence rate, no statistical difference could be found（ P 〉 0.05 ）. No serious DAR appeared during the medical treatment. Conclusion： Ulinastatin combined with basic medical treatment had its reliable and remarkable medical treatment effect on patients with septic shock with high security, and could obviously reduce the MODS occurrence rate, whose curative eflect was closely related with the inhibition of the release of serum IL-6 and PCT and promotion of the release of IL-10.