去乙酰毛花甙联合乌司他丁对大面积烧伤患者血清cTnI、TBA和β_2-MG的影响

Influence of deslanoside combined with ulinastatin on serum cTnI,TBA and β_2-MG of the patients with large-area burns

目的探讨去乙酰毛花甙联合应用乌司他丁对大面积烧伤患者血清cTnI、TBA、β2-MG及其多脏器功能障碍综合征(MODS)的影响。方法采用微粒子酶免法、酶循环法、比浊法测定41例应用乙酰毛花甙联合乌司他丁(A组)、34例应用乙酰毛花甙(B组)、38例应用乌司他丁(C组)、34例去乙酰毛花甙与乌司他丁均不加用(D组)患者伤后第2、6天心肌肌钙蛋白(cTnI)、总胆汁酸(TBA)、β2-微球(β2-MG)水平,同时对比分析4组MODS发生率、病死率。结果 4组伤后第2天血清中cTnI、TBA、β2-MG水平比较无显著性差异(P=0.878;P=0.674;P=0.789),伤后第6天较第2天均显著降低(P<0.01;P<0.01;P<0.01),血清中cTnI、TBA、β2-MG水平整体比较均有显著性差异(P<0.001;P=0.005;P=0.004),其中,A组与D组比较均具有显著性差异(P=0.014;P<0.001;P=0.003)。147例共发生MODS 11例,发生率为7.48%,病死7例,病死率为4.76%。A、C组较D组MODS发生率显著降低(P=0.024;P=0.032),B、D组比较无显著性差异(P=0.283)。结论乙酰毛花甙合用乌司他丁能显著降低大面积烧伤血清cTnI、TBA、β2-MG水平及其MODS发生率。

Objective To discuss the influence of deslanoside plus ulinastatin on the serum cTnI,TBA,β2-MG and the multiple organ dysfunction syndrome（MODS） incidence of patients with large-area burns. Methods The 147 patients with large-area burns were randomly divided into 4 groups： 41 patients were treated with deslanoside and ulinastatin（as group A）,34 with deslanoside（as group B）,38 with ulinastatin （as group C） and 34 of the patients were treated without deslanoside and ulinastatin （as group D）. Their serum level of cTnI,TBA andβ2-MG were detected on the 2nd and 6th day after burn by the microparticle enzyme immunoassay （MEIA）, enzymatic cycling and turbidimetry methods,respectively. The difference of the detected data,incidence of MODS and mortality of the burn patients among 4 groups were analyzed with SPSS （version 11.0）. Results There were not any significant differences in the patients’ serum levels of cTnI,TBA and β2-MG among 4 groups on the 2nd day after burn,respectively （P=0.878;P=0.674;P=0.789）. These data which was obtained on the 2nd day after burn were significant lower than those on the 6th day,respectively （P＆lt;0.01;P＆lt;0.01;P＆lt;0.01）. There were significant differences in the patients’ serum levels of cTnI,TBA and β2-MG among 4 groups on the 6th day after burn, respectively （P＆lt;0.001;P=0.005;P=0.004）,and there was significant difference between A group and D group in above items respectively（P=0.014;P＆lt;0.001;P=0.003）;11（7.48%） of the 147 patients complicated with MODS,and 7 （4.76%） of them died. The incidence of MODS in group A and C were significantly lower than that in group D , respectively （P=0.024;P=0.032） and the difference of the incidence of MODS between group B and D was not significant （P=0.283）. Conclusion The serum cTnI,TBA,β2-MG and the incidence of MODS are decreased significantly in the large-area burn patients who treated with deslanoside combined with ulinastatin.