乌司他丁对肝肿瘤切除术患者肝缺血-再灌注损伤时炎症水平的影响

Clinical trial of ulinastatin on the levels of inflammation in hepatic ischemia-reperfusion injury patients with liver tumor resection

目的观察乌司他丁对肝肿瘤切除术患者肝缺血-再灌注损伤(HIRI)时炎症水平及内皮素(ET)-1、超氧化物歧化酶(SOD)、丙二醛(MDA)水平的影响。方法将进行肝肿瘤切除术的88例患者随机分为对照组43例和试验组45例。对照组术后给予异甘草酸镁注射液,每次0.1 g,每天2次,静脉滴注;试验组在对照组的基础上给予乌司他丁注射液,每次20万U,每天2次,静脉滴注。2组均连续治疗7 d。比较2组患者治疗前后炎症因子水平及血清一氧化碳(CO)、ET-1、SOD、MDA水平。观察2组的药物不良反应发生情况。结果治疗后,试验组和对照组血清IL-1β水平分别为(3.67±1.11),(4.51±1.21)pg·mL^-1;IL-6水平分别为(6.82±2.14),(8.28±2.63)pg·mL^-1;TNF-α水平分别为(3.36±0.77),(5.14±0.72)pg·mL^-1,CO水平分别为(21.57±6.24),(33.66±8.62)μmol·L-1;血清ET-1水平分别为(83.29±16.92),(108.26±17.54)pg·mL^-1,血清SOD水平分别为(189.21±36.23),(136.21±45.20)U·mL^-1,血清MDA水平分别为(3.75±0.97),(5.10±1.22)μmol·L^-1,差异均有统计学意义(均P<0.05)。试验组药物不良反应发生率为2.22%,对照组为18.60%,差异有统计学意义(P<0.05)。结论乌司他丁能够抑制肝肿瘤切除术患者肝缺血-再灌注损伤时的炎症反应,降低炎性因子水平,并且能够提供肝功能保护作用,降低药物不良反应发生率。

Objective To investigate the effect of ulinastatin on the levels of inflammation and endothelin(ET)-1,superoxide dismutase(SOD),malondialdehyde(MDA)in hepatic ischemia-reperfusion injury(HIRI)patients with liver tumor resection.Methods Eighty-eight patients who underwent hepatic tumor resection were randomly divided into control group(43 cases)and treatment group(45 cases).Control group was treated with magnesium isoglycyrrhizinate injection,0.1 g·time^-1,twice a day,intravenous infusion;treatment group was given ulinastatin injection,2.0×10^5 U·time^-1,twice a day,intravenous drip,on the basis of control group.Both groups were treated for 7 d.The levels of inflammatory factors,the levels of serum carbon monoxide(CO),ET-1,SOD,MDA before and after treatment were compared.The incidence of adverse drug reactions in two groups were observed.Results After treatment,the levels of serum IL-1βin treatment group and control groups were(3.67±1.11),(4.51±1.21)pg·mL^-1;the levels of serum IL-6 were(6.82±2.14),(8.28±2.63)pg·mL^-1;the levels of serum TNF-αwere(3.36±0.77),(5.14±0.72)pg·mL^-1;the levels of serum CO were(21.57±6.24),(33.66±8.62)μmol·L^-1;the levels of serum ET-1 were(83.29±16.92),(108.26±17.54)pg·mL^-1;the levels of serum SOD were(189.21±36.23),(136.21±45.20)U·mL^-1;the levels of serum MDA were(3.75±0.97),(5.10±1.22)μmol·L^-1,all with significant difference(all P<0.05).The incidence of adverse drug reactions in treatment group was 2.22%,and that in control group was 18.60%,with significant difference(P<0.05).Conclusion Ulinastatin can inhibit the inflammatory response during liver ischemia-reperfusion injury in patients with liver tumor resection,reduce the level of inflammatory factors,and provide liver function protection,reduce the incidence of adverse drug reactions.