大面积烧伤患者围手术期使用乌司他丁对心肌的保护作用

The protective effect of ulinastatin on the myocardium in patients with large area burns during the perioperative period

目的探讨大面积烧伤患者围手术期使用乌司他丁对心肌的保护作用。方法 66例进行手术治疗的大面积烧伤患者作为研究对象,随机分为观察组与对照组,每组33例。两组患者入院后均给予常规方法进行治疗,观察组在以上治疗的基础上加用乌司他丁注射液治疗。治疗前及治疗4、7 d时测定两组氨基末端脑钠肽前体(NT-pro BNP)和心型脂肪酸结合蛋白(h-FABP)水平,并进行组间比较。结果两组治疗前血浆NT-pro BNP比较差异无统计学意义(P>0.05);治疗4 d时两组血浆NT-pro BNP达到峰值,且观察组血浆NT-pro BNP(421.4±38.4)ng/ml明显低于对照组(592.5±36.1)ng/ml,差异具有统计学意义(P<0.01);治疗7 d时两组血浆NT-pro BNP均有降低,且观察组血浆NT-pro BNP(136.2±28.1)ng/ml明显低于对照组(301.1±29.5)ng/ml,差异具有统计学意义(P<0.01)。两组治疗前血浆h-FABP比较差异无统计学意义(P>0.05);治疗4 d时两组血浆h-FABP达到峰值,且观察组血浆h-FABP(19.15±3.37)ng/ml明显低于对照组(23.83±3.01)ng/ml,差异具有统计学意义(P<0.01);治疗7 d时两组血浆h-FABP均有降低,且观察组血浆h-FABP(2.09±0.41)ng/ml明显低于对照组(5.91±0.37)ng/ml,差异具有统计学意义(P<0.01)。结论大面积烧伤患者围手术期使用乌司他丁可以减轻心肌损伤,有利于患者恢复。

Objective To discuss the protective effect of ulinastatin on the myocardium in patients with large area burns during the perioperative period. Methods A total of 66 patients with large area burns undergoing surgical treatment as study subjects were randomly divided into observation group and control group, with 33 cases in each group. Both groups was treated with conventional therapy, and the observation group was also treated with ulinastatin injection. The levels of N-terminal pro brain natriuretic peptide（NT-pro BNP） and heart type fatty acid binding protein（h-FABP） before and after treatment for 4 and 7 d in two groups were measured and compared. Results Both groups had no statistically significant difference in plasma NT-pro BNP before treatment（P〈0.05）. After 4 d of treatment, the plasma NT-pro BNP reached its peak value in the two groups, and the observation group had obviously lower plasma NT-pro BNP as（421.4±38.4） ng/ml than（592.5±36.1） ng/ml in the control group. Their difference was statistically significant（P〈0.01）. After 7 d of treatment, both groups had lower plasma NT-pro BNP, and the observation group had obviously lower plasma NT-pro BNP as（136.2±28.1） ng/ml than（301.1±29.5） ng/ml in the control group. The difference was statistically significant（P〈0.01）. Both groups had no statistically significant difference in plasma h-FABP before treatment（P〈0.05）. After 4 d of treatment, the plasma h-FABP reached its peak value in the two groups, and the observation group had obviously lower plasma h-FABP as（19.15±3.37） ng/ml than（23.83±3.01） ng/ml in the control group. The difference was statistically significant（P〉0.01）. After 7 d of treatment, both groups had lower plasma h-FABP, and the observation group had obviously lower plasma h-FABP as（2.09±0.41） ng/ml than（5.91±0.37） ng/ml in the control group. The difference was statistically significant（P〈0.01）. Conclusion Application of ulinastatin for patients with large area burns during the perioperative period can relieve the injury of the myocardium and be beneficial to the recovery of the patients.