乌司他丁对肝切除术患者围术期炎症因子及肝功能的影响

Effect of ulinastatin on perioperative inflammatory factors and liver function in patients undergoing hepatectomy

目的观察乌司他丁对肝切除术患者围术期炎症因子及肝功能的影响。方法选取2013年5月至2015年7月北京大学深圳医院外科收治的肝切除术患者68例为研究对象,按随机数字表法分为研究组和对照组,每组34例。对照组患者术后给予基础药物治疗,研究组患者在基础药物治疗的基础上给予乌司他丁,比较两组患者围术期炎症因子包括白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、肝功能指标包括丙氨酸转移酶(ALT)、天冬氨酸转氨酶(AST)水平变化,并观察两组患者治疗后的药物不良反应发生情况。结果术后3 d两组患者IL-6、IL-8、TNF-α、ALT、AST均较术前显著升高,且对照组较研究组升高显著,术后7 d两组患者IL-6、IL-8、TNF-α、ALT、AST较术后3 d显著下降,且研究组较对照组下降显著,术后7 d仅对照组患者IL-6、IL-8、TNF-α、ALT、AST较术前显著升高,差异均有统计学意义(均P<0.05);研究组患者的药物不良反应总发生率为11.8%,高于对照组的5.9%,但差异无统计学意义(P>0.05)。结论乌司他丁对肝切除术患者围术期炎症因子具有显著抑制作用,对患者术后肝功能有一定的保护效果,是一种疗效确切、安全可靠的药物。

Objective To study the effect of ulinastatin on perioperative inflammatory factors and liver function in patients undergoing hepatectomy.Methods From May 2013 to Jul.2015,a total of 68 patients undergoing hepatectomy in our hospital were taken as the clinical research objects,and they were randomly divided into study group and control group.After operation,the control group was given conventional drug therapy,and the study group was given Ulinastatin in order to compare their perioperative changes of inflammatory factors[interleukin-6（IL-6）,interleukin-8（IL-8）,tumor necrosis factor-α（TNF-α）]and liver function indexes[alanine aminotransferase（ALT）,aspartate aminotransferase（AST）]and adverse drug reactions.Results 3d after operation,the IL-6,IL-8,TNF-α,ALT and AST increased significantly in the two groups compared with those before operation,and the control group increased more significantly;7d after operation,the IL-6,IL-8,TNF-α,ALT and AST decreased significantly in the two groups compared with those 3d after operation,and the study group decreased more significantly;7d after operation,the IL-6,IL-8,TNF-α,ALT and AST increased significantly in the two groups compared with those before operation,and their differences were statistically significant（P〈0.05）;The incidence of adverse drug reactions in the study group was 11.8%higher than that in the control group（5.9%）,and the difference was not statistically significant（P〉0.05）.Conclusion Ulinastatin has not only obvious inhibitory effect on perioperative inflammatory factors,but also certain protective effect on the liver function in patients undergoing hepatectomy,Is a reliable,safe and reliable drug regimen.