乌司他丁对毛细血管渗漏综合征新生儿不同时间PTM水平及Alb水平的影响

Effects of ulinastatin on PTM and Alb levels at different time in neonates suffered with capillary leaksyndrome

目的深入探究乌司他丁药物对新生儿毛细血管渗漏综合征(capillary leak syndrome,CLS)不同时间血浆血栓调节蛋白(PTM)及白蛋白(Alb)水平的影响。方法选择2019年6月—2021年6月本院出生的100例毛细血管渗漏综合征新生儿作为研究对象,按照随机数表法分为研究组和对照组两组,每组各50例。研究组患儿接受乌司他丁治疗,对照组通过羟乙基淀粉进行治疗,对比分析两组患儿在接受治疗后第2天、第5天及第7天血液中PTM、Alb的浓度以及药物不良反应情况,观察其血清中肿瘤坏死因子-α(TNF-α)、白细胞介素IL-10、IL-6表达量、肺血管通透性指标以及血管外肺水指标。结果两组PTM水平在用药前和用药后2天间比较差异无统计学意义(P<0.05),在用药5天和用药7天研究组PTM水平均低于对照组(P<0.05);在用药前后及用药后2天,比较两组患儿的Alb浓度差异不明显(P>0.05),用药5天和用药7天后研究组Alb水平高于对照组(P<0.05);研究组和对照组的不良反应发生率分别为4.00%和2.00%,两者比较均未见差异性(P>0.05)。治疗前研究组的TNF-α、IL-10、IL-6表达量以及血管外肺水以及肺血管通透性指标与对照组相比较,结果无差异性(P<0.05),在两组患儿治疗后,结果与对照组相比,乌司他丁治疗组患儿的TNF-α、IL-6表达以及血管外肺水和肺血管通透性指标明显降低(P<0.05),乌司他丁治疗组患儿的IL-10表达量显著高于对照组(P<0.05)。结论CLS患儿在接受乌司他丁药物治疗后,可有效缓解炎症,改善血管通透性,阻止Alb外渗,增加血清中Alb的同时降低PTM浓度水平,同时对血管内皮组织起到一定保护作用,具有良好的有效性和安全性。

Objective To investigate the effect of ulinastatin on the levels of plasma thrombomodulin(PTM)and albumin(ALB)in neonatal capillary leak syndrome(CLS).Methods 100 newborns suffered with capillary leakage syndrome those were born in our hospital from June 2019 to June 2021 were taken as the research objects,and according to random number table method they were randomly divided into the study group and the control group,with 50 cases in each group.The children in the study group were treated with Ulinastatin and the children in the control group were treated with hydroxyethyl starch.The concentration of blood PTM,Alband adverse drug reactions on the 2nd,5th and 7th days after treatment were compared and analyzed.The expression of tumor necrosis factor-α(TNF-α),interleukin-10 and IL-6,pulmonary vascular permeability and extravascular lung water were observed.Results There was no significant difference in the level of PTM between the two groups before treatment and 2 days after treatment(P<0.05).The level of PTM in the study group was significantly lower than that in the control group on 5thand 7thday after treatment(P<0.05).There was no significant difference in ALB concentration between the two groups before treatment and 2 days after treatment(P>0.05).ALB level in the study group was significantly higher than that in the control group 5 days and 7 days after treatment(P<0.05).The incidence of adverse reactions in the study group and the control group were 4.00%and 2.00%respectively,and there was no significant difference between them(P>0.05).There was no significant difference in the expression of TNF-α,IL-10 and IL6,extravascular lung water and pulmonary vascular permeability between the two groups and the control group before treatment(P<0.05).After treatment,the results showed that the the expression ofTNF-α,IL-6,and the indexes of extravascular lung water and pulmonary vascular permeability of children in Ulinastatin treatment groupdecreased significantly(P<0.05).The expression of IL-10 in Ulinastatin treatment group was significantly higher than that in control group(P<0.05).Conclusions After children with CLSreceiving the treatment of Ulinastatin,inflammation was effectively alleviated,vascular permeability was improved,ALB extravasation was prevent,ALB in serum was increased and PTM concentration was reduced.At the same time,Ulinastatincan protect vascular endothelial tissue,which has good effectiveness and safety.