乌司他丁对多发伤合并感染患者应用价值探讨

Exploration of the application value of ulinastatin in patients with multiple trauma and infection

目的探索乌司他丁对多发伤合并感染患者治疗中炎症状态、免疫功能及凝血指标的影响。方法选取2020-05-08-2023-04-20郑州市第一人民医院收治的84例多发伤合并感染患者为研究对象,依照治疗方式不同分为对照组和联合组。2组患者均给予对症基础治疗,对照组42例给予血必净治疗,联合组42例在对照组基础上联合乌司他丁治疗,单因素协方差分析对比2组患者炎症状态、免疫功能和凝血指标。结果联合组治疗1周后肿瘤坏死因子α(TNF-α)水平为(31.68±4.76)ng/L,低于对照组的(38.91±6.07)ng/L,白细胞介素-6(IL-6)水平为(36.08±8.62)ng/L,低于对照组的(44.75±10.15)ng/L,降钙素原(PCT)水平为(1.03±0.29)mg/mL,低于对照组的(1.54±0.36)mg/mL,差异有统计学意义,F值分别为1528.423、250.711和445.479,均P<0.001。联合组治疗1周后CD3^(+)水平为(60.08±9.73)%,高于对照组的(49.63±7.42)%,CD4^(+)水平为(44.91±8.06)%,高于对照组的(37.96±6.51)%,CD4^(+)/CD8^(+)水平为1.58±0.81,高于对照组的1.29±0.65,差异有统计学意义,F值分别为462.671、670.528和20.630,均P<0.001。联合组治疗1周后纤维蛋白原(FIB)水平为(3.31±0.82)g/L,高于对照组的(2.58±0.67)g/L,凝血酶原时间(PT)水平为(12.16±2.84)s,低于对照组的(16.08±3.51)s,活化部分凝血酶时间(APTT)为(34.23±3.51)s,低于对照组的(37.48±3.72)s,差异有统计学意义,F值分别为1172.372、127.816和475.761,均P<0.001。结论乌司他丁可调节多发伤合并感染患者凝血指标,改善炎症状态,调控免疫功能。

Objective To explore the effects of ulinastatin on inflammatory state,immune function and coagulation indices in patients with multiple injuries combined with infection.Methods A total of 84patients with multiple injuries combined with infection admitted to Zhengzhou First People's Hospital from May 8,2020to April 20,2023were selected as the study objects,and were divided into control group and combination group according to different treatment methods.The two groups were given symptomatic basic treatment.The control group(n=42)was treated with Xuebijing,while the combined group(n=42)was treated with ulinastatin on the basis of the control group.Univariate co-variance analysis was used to compare the inflammatory status,immune function,and coagulation indices between the two groups of patients.Results After 1week of treatment,the level of tumor necrosis factorα(TNF-α)was(31.68±4.76)ng/L,which was lower than that of control group(38.91±6.07)ng/L,and the level of interleukin-6(IL-6)was(36.08±8.62)ng/L,lower than the control group's(44.75±10.15)ng/L,the level of procalcitonin(PCT)was(1.03±0.29)mg/ml,lower than the control group's(1.54±0.36)mg/ml,the difference was statistically significant,with F-values of 1528.423,250.711and 445.479,all P<0.001.After 1week of treatment,the level of CD3^(+)in the combination group was(60.08±9.73)%,higher than that in the control group's(49.63±7.42)%,the level of CD4^(+)was(44.91±8.06)%,higher than that in the control group's(37.96±6.51)%,and the CD4^(+)/CD8^(+)level was 1.58±0.81,higher than the control group's 1.29±0.65,the differences were statistically significant,with F-values of 462.671,670.528,and 20.630,all P<0.001.After 1week of treatment,the fibrinogen(FIB)level in the combination group was(3.31±0.82)g/L,higher than that in the control group's(2.58±0.67)g/L,and the prothrombin time(PT)level was(12.16±2.84)s,lower than that in the control group's(16.08±3.51)s,the activated partial thrombin time(APTT)was(34.23±3.51)s,lower than that of the control group's(37.48±3.72)s,and the difference was statistically significant,with Fvalues of 1172.372,127.816and 475.761,all P<0.001.Conclusion Ulinastatin can regulate coagulation index,ed,September 2024,Vol.22 No.18·627·improve inflammatory state and regulate immune function in patients with multiple injuries combined with infection.