乌司他丁对脓毒性休克婴幼儿白介素-1、肿瘤坏死因子α及降钙素原的影响

Effects of Ulinastatin on Interleukin-1,Tumor Necrosis Factor-α and Procalcitonin Levels in Infants with Septic Shock

目的探讨乌司他丁对脓毒性休克婴幼儿白介素-1(IL-1)、肿瘤坏死因子α(TNF-α)及降钙素原(PCT)的影响。方法将60例脓毒性休克患儿按随机数字表法分为对照组和治疗组,每组30例。对照组给予抗休克和病因治疗,治疗组在对照组治疗的基础上,给予乌司他丁2万U·kg-1加入5%葡萄糖注射液50 mL中静脉滴注,q8h。2组均5 d为1个疗程。2组患儿分别于入住ICU时及治疗5 d后采集静脉血4 mL,测定TNF-α、IL-1及PCT,观察治疗前后TNF-α、IL-1及PCT水平的变化。结果 2组治疗前IL-1、TNF-α和PCT水平的变化比较差异均无统计学意义(均P>0.05);治疗组治疗5 d后IL-1、TNF-α和PCT分别为(86.48±17.29)pg·L-1、(105.86±20.79)pg·L-1和(5.33±0.85)ng·mL-1,对照组治疗5 d后IL-1、TNF-α和PCT分别为(112.34±18.54)pg·L-1、(189.04±28.36)pg·L-1和(8.54±1.43)ng·mL-1,治疗组明显低于对照组(均P<0.05)。结论乌司他丁对脓毒性休克婴幼儿IL-1、TNF-α及PCT有明显降低作用,从而能改善患儿的预后。

Objective To investigate the effects of ulinastatin on the levels of interleukin-1（IL-1）, tumor necrosis factor-α（TNF-α） and procalcitonin（PCT） in infants with septic shock. Methods Sixty infants with septic shock were randomly divided into two groups,with 30 infants in each group. The control group was given anti-shock and etiological treatment. On this basis,the treatment group was given intravenous drip of ulinastatin （20 000 U·kg-1 in 50 mL of 5% glucose solution, once every 8 hours）.The course of treatment was 5 days.Venous blood samples（4 mL）were taken after ICU admission and treatment for 5 days to determine the levels of IL-1,TNF-α and PCT in both groups. Results There were no significant differences in the levels of IL-1,TNF-α and PCT between the two groups before treatment（P〉0.05）. Compared with control group,the levels of IL-1,TNF-αand PCT significantly decreased in treatment group after treatment for 5 days [（86.48±17.29）pg·L-1 vs（112.34±18.54）pg·L-1, （105.86±20.79）pg·L-1 vs （189.04±28.36）pg·L-1 and （5.33±0.85）ng·mL-1 vs （8.54±1.43）ng·mL-1, respectively; P＆lt;0.05]. Conclusions Ulinastatin treatment can reduce the levels of IL-1, TNF-α and PCT and improve the prognosis in infants with septic shock.