连续肾脏替代联合乌司他丁治疗多器官功能障碍综合征效果

Effects of continuous renal replacement combined with Ulinastatin on multiple organ dysfunction syndrome

目的探讨连续肾脏替代(CRRT)联合乌司他丁对多器官功能障碍综合征(MODS)的疗效及对血清降钙素原(PCT)水平的影响。方法选取自2012年8月至2018年6月收治的78例MODS患者为研究对象,根据治疗方法的不同分为常规组(n=38)与乌司他丁组(n=40)。常规组给予常规CRRT治疗,乌司他丁组在常规组治疗的基础上给予乌司他丁治疗,记录两组预后情况与PCT变化。结果乌司他丁组的ICU停留时间为(7.21±1.92)d、呼吸机辅助时间为(3.43±1.81)d,均短于常规组的ICU停留时间(10.63±2.17)d、呼吸机辅助时间(6.75±1.84)d,差异有统计学意义(P<0.05)。乌司他丁组的病死率为7.9%(3/38),常规组的病死率为5.0%(2/40),组间比较,差异无统计学意义(P>0.05)。治疗前,两组患者PCT、白细胞介素-6、白细胞介素-8比较,差异无统计学意义(P>0.05);治疗后,两组患者上述指标均低于治疗前,且乌司他丁组显著低于常规组,差异均有统计学意义(P<0.05)。治疗前,两组患者血肌酐、尿素氮比较,差异无统计学意义(P>0.05);治疗后,两组患者上述指标均显著低于治疗前,差异均有统计学意义(P<0.05);两组间上述指标比较,差异无统计学意义(P>0.05)。结论 CRRT联合乌司他丁治疗MODS患者可抑制PCT的释放与炎症因子的表达,缩短恢复时间,改善患者的肾功能。

Objective To investigate the effects of continuous renal replacement therapy(CRRT)combined with Ulinastatin on multiple organ dysfunction syndrome(MODS)and serum procalcitonin(PCT)level.Methods A retrospective study was performed on 78 cases of patients with MODS who were admitted from August 2012 to June 2018.According to different treatments,patients were divided into the conventional group(n=38)and the Ulinastatin group(n=40).The conventional group of patients were treated with conventional CRRT,and the Ulinastatin group of patients were treated with Ulinastatin on the basis of the treatment of the conventional group,and the prognosis and PCT changes of the two groups were recorded.Results The ICU residence time(7.21±1.92)days and ventilator assisted time(3.43±1.81)days in the Ulinastatin group were both shorter than those in the conventional group(10.63±2.17)days and ventilator assisted time(6.75±1.84)days,with statistically significant differences(P<0.05).The case fatality rate of Ulinastatin group was 7.9%(3/38)and 5.0%(2/40),and the difference was not statistically significant(P>0.05).Before treatment,PCT,interleukin(IL)-6 and IL-8 of the two groups showed no significant difference(P>0.05).After treatment,the above indicators of patients in both groups were lower than those before treatment,and the Ulinastatin group was significantly lower than the conventional group(P<0.05).Before treatment,serum creatinine and blood urea nitrogen were compared between the two groups,and the difference was not statistically significant(P>0.05).After treatment,the above indexes of patients in both groups were significantly lower than those before treatment(P<0.05),while the differences between the two groups were not statistically significant(P>0.05).Conclusion CRRT combined with Ulinastatin in the treatment of MODS patients can inhibit the release of PCT and the expression of inflammatory factors,shorten the recovery time and improve the renal function of patients.