乌司他丁对脓毒症患者器官功能的保护作用

Protective Effect of Ulinastatin on Multiple Organ Function in Patients with Sepsis

目的:探讨乌司他丁(UTI)对脓毒症患者C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平的影响及心肝肾的保护作用。方法:将68例脓毒症患者按随机双盲法分为UTI组和常规组。常规组进行常规治疗,包括:早期复苏、监测乳酸指导补液、抗菌药物应用、机械通气、血液净化;UTI组在常规治疗基础上,加用UTI 30万单位,溶于0.9%生理盐水50 mL,静脉滴注,2次/d,每次1 h滴完,共7 d。于治疗前和治疗后第8天测定血浆CRP水平、TNF-α和IL-6水平及心肝肾生化指标。结果:治疗后,两组CRP、TNF-α、IL-6水平与治疗前比较差异均有统计学意义(P<0.05),而UTI组差异更为明显(P<0.05);两组血浆丙氨酸转氨酶(ALT)、天冬氨酸转氨酸转氨酶(AST)、肌酐(Cr)、尿素(BUN)、尿酸(UA)较治疗前均明显降低,差异均有统计学意义(P<0.05),而UTI组降低更为显著(P<0.05);两组血浆乳酸脱氢酶(LDH)、肌酸激酶(CK)及其同工酶(CK-MB)均较治疗前均明显降低,差异均有统计学意义(P<0.05),而UTI组降低更为显著(P<0.05)。结论:乌司他丁显著降低CRP、TNF-α、IL-6水平,对脓毒症患者的心肝肾功能有较好的保护作用。

Objective：To investigate the protective mechanism and efficacy of ulinastatin （UTI） on level of C-reactive protein （CRP）, interleukin-6 （IL-6）, tumor necrosis factor-α（TNF-α） and heart kidney liver organ function in patients with sepsis.Method：68 patients with sepsis were divided into UTI group and routine group according to the random double blind method. The routine group was given routine treatment, included： early recovery, monitoring lactate guiding rehydration, antibiotics application, mechanical ventilation, blood purification; on the basis of conventional treatment,the UTI group was given 300 000 units UTI, and soluble in 0.9% saline 50 mL, intravenous drip, 2 times / day, each 1 h drip off, for 7 days. TNF-α, IL-6 CRP and other heart and kidney biochemical indexes were determined before the treatment and 8 days after the treatment of the two groups.Result： After treatment, CRP, TNF-α, IL-6 levels of two groups were compared with before treatment, the differences had statistical significance （P〈0.05）, while the UTI group had more significant difference （P〈0.05）. ALT, AST, BUN, Cr and UA of two groups were significantly lower compared with before treatment, the differences had statistical significance （P〈0.05）, while the UTI group decreased significantly （P〈0.05）; LDH, CK and CK - MB were significantly lower of two groups compared with before treatment, and the differences were statistically significant （P〈0.05）, while the UTI group decreased significantly （P〈0.05）.Conclusion：UTI has beneficial effects on the protection of liver kidney heart in patients with sepsis.