乌司他丁联合参麦注射液治疗感染性休克的临床研究

Clinical research of ulinastatin combined with Shenmai Injection in treatment of septic shock

目的探讨注射用乌司他丁联合参麦注射液治疗感染性休克的临床研究。方法选取2014年2月-2017年6月在安阳市人民医院诊治的感染性休克患者70例作为研究对象,随机分为观察组(35例)和对照组(35例)。对照组患者以5 mL/h的速度持续泵入参麦注射液12 h。观察组患者在对照组基础上静脉滴注注射用乌司他丁,将20万U溶解于100 mL生理盐水内,2次/d。两组均连续治疗3 d。观察两组患者的临床疗效,比较两组血清C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)水平、病死率及多器官功能障碍综合征(MODS)发生率。结果治疗后,观察组患者临床治疗有效率为94.29%,对照组患者的临床治疗有效率为71.43%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者血清内CRP、PCT及IL-6水平均明显降低,同组治疗前后比较差异有统计学意义(P<0.05);且观察组患者CRP、PCT及IL-6水平均显著低于对照组,两组比较差异具有统计学意义(P<0.05)。与对照组相比,观察组患者的病死率和MODS发生率均显著降低,差异具有统计学意义(P<0.05)。结论注射用乌司他丁联合参麦注射液治疗感染性休克的临床效果较好,可显著降低血清炎性反应并有效改善病死率。

Objective To investigate the clinical research of Ulinastatin for Injection combined with Shenmai Injection in treatment of septic shock. Methods Patients(70 cases) with septic shock in The People’s Hospital of Anyang City from Feburary 2014 to June2017 were randomly divided into observation group(35 cases) and control group(35 cases). Patients in the control group were continuously pumped Shenmai Injection for 12 h at the rate of 5 mL/h. Patients in the observation group were iv administered with Ulinastatin for Injection on the basis of control group, 200 000 U dissolved in 100 mL normal saline, twice daily. Patients in two groups were treated for 3 d. After treatment, the clinical efficacies were evaluated, and the serum CRP, PCT, IL-6 levels, mortality and MODS in two groups were compared. Results After treatment, the effective rate in the observation group was 94.29%, the effective rate in the control group was 71.43%, and there was difference between two groups(P < 0.05). After treatment, the serum CRP, PCT and IL-6 levels in two groups were significantly decreased, and the difference was statistically significant in the same group(P < 0.05). And the levels of CRP, PCT and IL-6 in the observation group were significantly lower than those in the control group, with significant difference between two groups(P < 0.05). Compared with the control group, the mortality and the incidence of multiple organ disfunction syndrome in the observation group were significantly decreased, the difference was statistically significant(P < 0.05). Conclusion Ulinastatin for Injection combined with Shenmai Injection has good clinical effect in treatment of septic shock, can significantly decreased the serum inflammatory response, and effectively improve mortality.