乌司他丁联合血液净化用于重症脓毒症炎症介质清除的疗效观察

Effect of ulinastatin combined with blood purification on clearing inflam matory mediators in severe sepsis

目的:观察乌司他丁联合血液净化用于重症脓毒症炎症介质清除的疗效。方法:选取2021年1月至12月宁夏回族自治区人民医院收治的68例重症脓毒症患者为试验对象,随机将其分为对照组(34例,常规治疗+连续性血液净化)和观察组(34例,常规治疗+连续性血液净化+乌司他丁静脉滴注)。对比两组的炎症介质清除效果及其他临床指标。结果:观察组的ICU住院时间和机械通气时间均显著短于对照组,28 d病死率显著低于对照组(P<0.05)。治疗后,观察组的序贯器官衰竭估计(SOFA)评分为(8.12±2.14)分,显著低于对照组的(13.59±1.52)分(P<0.05)。治疗后,两组的白细胞计数、中性粒细胞百分比及白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平均显著低于治疗前,且观察组均显著低于对照组(P<0.05)。结论:针对重症脓毒症患者,给予乌司他丁联合血液净化治疗可有效清除体内的炎症介质,促进患者的恢复。

Objective:To observe the efficacy of ulinastatin combined with blood purification in the removal of inflammatory mediators in severe sepsis.Methods:A total of 68 patients with severe sepsis admitted to the People’s Hospital of Ningxia Hui Autonomous Region from January to December 2021 were selected as test subjects and randomly divided into control group(34 cases,conventional treatment+continuous blood purification)and observation group(34 cases,conventional treatment+continuous blood purification+ulinastatin intravenous infusion).The scavenging effect of inflammatory mediators and other clinical indicators were compared between the two groups.Results:The ICU stay time and mechanical ventilation time of observation group were significantly shorter than control group,and the 28-day mortality was significantly lower than control group(P<0.05).After treatment,the SOFA score of the observation group was(8.12±2.14),significantly lower than that of the control group(13.59±1.52)(P<0.05).After treatment,the leukocyte count,neutrophil percentage,interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)levels in 2 groups were significantly lower than before treatment,and the observation group were significantly lower than control group(P<0.05).Conclusion:For patients with severe sepsis,ulinastatin combined with blood purification therapy can effectively remove inflammatory mediat ors in the body and promote the recovery of patients.