乌司他丁治疗急性心衰患者临床疗效观察

Observation of clinical effect by ulinastatin in the treatment of acute heart failure

目的探讨乌司他丁治疗急性心力衰竭(心衰)患者的临床疗效。方法 120例急性心衰患者,随机分为观察组与对照组,各60例。对照组按照《中国心力衰竭诊断和治疗指南2014》给予急诊处理,观察组在对照组治疗基础上给予乌司他丁治疗。比较两组患者治疗前后血浆钠尿肽(BNP)、肌钙蛋白I(c Tn I)、白介素-6(IL-6)与肿瘤坏死因子-α(TNF-α)水平变化,比较两组患者呼吸机辅助通气支持率、肺部感染发生率、心肾综合征发生率、多器官功能障碍综合征(MODS)发生率以及病死率差异。结果两组治疗后血浆BNP、c Tn I、IL-6、TNF-α水平均低于治疗前,观察组低于对照组,差异均具有统计学意义(P<0.05)。治疗后,观察组呼吸机辅助通气支持率(11.67%)、肺部感染发生率(25.00%)、心肾综合征发生率(8.33%)、MODS发生率(10.00%)及病死率(8.33%)均低于对照组,差异均有统计学意义(P<0.05)。结论乌司他丁辅助治疗急性心衰患者可以有效改善左心室功能,降低临床心衰后并发症发生率。分析原因与乌司他丁有效抑制急性心衰后患者体内炎性反应水平有关。

Objective To investigate clinical effect by ulinastatin in the treatment of acute heart failure. Methods A total of 120 acute heart failure patients were randomly divided into observation group and control group, with 60 cases in each group. The control group received emergency treatment in accordance with China diagnosis and treatment guidelines for heart failure 2014, and the observation group received additional ulinastatin for treatment. Comparison was made on changes of plasma brain natriuretic peptide（BNP）, troponin I（c Tn I）, interleukin-6（IL-6） and tumor necrosis factor-α（TNF-α） before and after treatment, ventilator-assisted ventilation approval rate, incidence of pulmonary infection, cardiorenal syndrome, multiple organ dysfunction syndrome（MODS） and mortality rate between the two groups. Results Both groups had lower plasma BNP, c Tn I, IL-6 and TNF-α levels after treatment than those before treatment, and the observation group had lower levels than the control group. Their differences all had statistical significance（P〈0.05）. After treatment, the observation group had all lower ventilator-assisted ventilation approval rate（11.67%）, incidence of pulmonary infection（25.00%）, incidence of cardiorenal syndrome（8.33%）, incidence of MODS（10.00%） and mortality rate（8.33%） than the control group. Their differences all had statistical significance（P〈0.05）. Conclusion Ulinastatin in assistant treatment of acute heart failure can effectively improve left ventricular function, reduce incidence of clinical complications after heart failure. Cause analysis shows related inhibition of inflammatory reaction in patients after acute heart failure.