乌司他丁与血必净联用治疗感染性休克对各PICCO监测指标、IL-6、PCT、BNP及NAGL水平的影响分析

Analysis of the effect of ulinastatin combined with Xuebijing on PICCO monitoring indicators, IL-6, PCT, BNP and NAGL levels during the treatment of septic shock

目的研究乌司他丁与血必净联用治疗感染性休克对各脉搏指示连续心排血量(PICCO)监测指标、白细胞介素-6(IL-6)、降钙素原(PCT)、脑钠肽(BNP)、中性粒细胞明胶酶相关脂质运载蛋白(NAGL)水平的影响。方法86例感染性休克患者,随机分成对照组和观察组,每组43例。对照组采取常规治疗方法,观察组在对照组的基础上给予乌司他丁与血必净联用治疗。观察比较两组患者治疗前后PICCO监测指标[心输出量(CO)、心排血指数(CI)、体循环阻力(SVR)、血管外肺水指数(EVLWI)]及IL-6、PCT、BNP、NAGL水平。结果治疗后,观察组患者的CO、CI及EVLWI水平分别为(4.33±0.29)L/min、(4.08±0.23)L/(min·m^2)、(4.37±0.20)ml/kg,低于对照组的(6.51±0.17)L/min、(5.47±0.26)L/(min·m^2)、(5.88±0.75)ml/kg,SVR水平(1219.75±86.54)dyn·s/cm5高于对照组的(1156.88±89.32)dyn·s/cm5,差异具有统计学意义(P<0.05)。治疗后,观察组患者的IL-6、PCT、BNP及NAGL水平分别为(145.82±10.27)ng/L、(0.79±0.15)ng/ml、(2449.12±45.37)pg/ml、(58.7±10.5)ng/ml,均低于对照组的(193.25±9.37)ng/L、(1.42±0.18)ng/ml、(4232.89±64.57)pg/ml、(79.5±18.3)ng/ml,差异具有统计学意义(P<0.05)。结论乌司他丁联用血必净治疗对改善感染性休克患者血流动力学指标及相关炎性因子水平具有显著效果,值得临床推广。

Objective To study the effect of ulinastatin combined with Xuebijing on pulse indicator continuous cardiac output(PICCO)monitoring indicators,interleukin-6(IL-6),procalcitonin(PCT),B-type natriuretic peptide(BNP)and neutrophil gelatinase associated lipocalin(NAGL)levels during the treatment of septic shock.Methods A total of 86 septic shock patients were randomly divided into control group and observation group,with 43 cases in each group.The control group received conventional therapy for treatment,and the observation group received ulinastatin combined with Xuebijing for treatment on the basis of the control group.Observation and comparison were made on PICCO monitoring indicators[cardiac output(CO),cardiac index(CI),systemic vascular resistance(SVR),extravascular lung water index(EVLWI)],and levels of IL-6、PCT、BNP,NAGL before and after treatment between the two groups.Results After treatment,the levels of CO,CI and EVLWI were(4.33±0.29)L/min,(4.08±0.23)L/(min·m^2)and(4.37±0.20)ml/kg in the observation group,which was lower than(6.51±0.17)L,(5.47±0.26)L/(min·m^2)and(5.88±0.75)ml/kg in the control group,and SVR level(1219.75±86.54)dyn·s/cm5 was higher than(1156.88±89.32)ml/min in the control group.Their difference was statistically significant(P<0.05).After treatment,the levels of IL-6,PCT,BNP and NAGL were(145.82±10.27)ng/L,(0.79±0.15)ng/ml,(2449.12±45.37)pg/ml and(58.7±10.5)ng/ml in the observation group,which was lower than(193.25±9.37)ng/L,(1.42±0.18)ng/ml,(4232.89±64.57)pg/ml and(79.5±18.3)ng/ml in the control group,and their difference was statistically significant(P<0.05).Conclusion Ulinastatin combined with Xuebijing shows significant effect on improving hemodynamic indexes and related inflammatory factors in patients with septic shock,and it is worthy of clinical promotion.