乌司他丁对重症脓毒症患者肠屏障功能及菌群移位的影响

Effects of ulinastatin on intestinal barrier function and flora translocation in patients with severe sepsis

目的探讨乌司他丁对重症脓毒症患者肠屏障功能及菌群移位的影响。方法选择2013年1月至2015年12月我院收治的重症脓毒症患者80例,按照随机数字法分为观察组与对照组,各40例。对照组行常规治疗,包括抗菌、维持内环境稳定、营养支持等对症支持处理,观察组在对照组基础上使用乌司他丁注射液治疗。比较治疗前、后两组患者的血清内毒素水平及24 h尿99 m Tc-DTPA排泄率。结果治疗后,两组的血清内毒素水平明显低于治疗前,且观察组明显低于对照组(P<0.05)。治疗后,两组的24 h尿99 m Tc-DTPA排泄率明显高于治疗前,且观察组明显高于对照组(P<0.05)。结论重症脓毒症患者使用乌司他丁能有效提高胃肠道屏障功能,降低胃肠道中内毒素水平,进而提高胃肠道功能。

Objective To investigate the effect of ulinastatin on intestinal barrier function and flora translation in patients with severe sepsis.Methods Eighty cases of severe sepsis patients admitted in our hospital from January 2013 to December 2015 were divided into observation group and control group according to the random number method,with 40 cases in each group.The control group was treated with routine treatment,such as antibacterial,maintenance of internal stability,nutritional support and other symptomatic support treatment;and the observation group was given ulinastatin based on the control group.The levels of serum endotoxin and the urinary 99 mTc-DTPA excretion rates in 24 h were compared between the two groups.Results After treatment,the levels of serum endotoxin of the two groups were lower than those before treatment,and those of the observation group were lower than the control group(P<0.05).After treatment,the 24 h urinary 99 mTc-DTPA excretion levels of the two groups were higher than those before treatment,and those of the observation group were higher than the control group(P<0.05).Conclusion Ulinastatin can improve gastrointestinal barrier function,reduce endotoxin level in gastrointestinal tract and improve gastrointestinal function in patients with severe sepsis.