乌司他丁联合CRRT在ICU感染性休克中的应用研究

Application of Ulinastatin Combined with CRRT in Septic Shock in ICU

目的探讨乌司他丁联合CRRT治疗ICU感染性休克的临床效果。方法选择38例ICU感染性休克患者,随机分为对照组和治疗组各19例。对照组给予常规治疗加CRRT治疗;治疗组在对照组的基础上增加乌司他丁治疗,比较两组患者治疗前、治疗7 d后血白细胞、C反应蛋白(CRP)、肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、氧合指数及急性生理和慢性健康状况评分系统Ⅱ(APACHEⅡ评分),以及两组患者治疗7 d后病死率。结果治疗后,两组患者血白细胞、C反应蛋白(CRP)、肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)均较治疗前降低,且治疗组降低更明显,差异具有统计学意义(P<0.05)。治疗后,两组患者氧合指数比治疗前均有升高,且治疗组升高更明显(P<0.05);治疗后,APACHEⅡ评分均有下降,且治疗组下降更明显,差异具有统计学意义(P<0.05)。结论乌司他丁联合CRRT治疗感染性休克,能使血清炎性因子明显减少,患者的呼吸功能得到改善,氧合指数明显升高,效果显著,临床可以推广应用。

Objective To investigate the clinical effect of ulinastatin combined with CRRT in the treatment of septic shock in ICU.Methods Thirty-eight ICU patients with septic shock were randomly divided into control group and treatment group.The control group was treated with conventional therapy plus CRRT.Treatment group in the control group on the basis of increasing ulinastatin treatment,compared two groups of patients before treatment,leukocyte count after 7 days of treatment,C-reactive protein(CRP),tumor necrosis factor(TNF alpha),interleukin-6(IL-6),interleukin 10(IL-10),oxygenation index and acute physiology and chronic health evaluation systemⅡ(APACHEⅡscore),mortality rate after 7 days of treatment in two groups.Results After treatment,the blood leucocytes,C-reactive protein(CRP),tumor necrosis factor(TNF-alpha),interleukin-6(IL-6),interleukin-10(IL-10)in the two groups were all lower than those before treatment,and the decrease in the treatment group was more obvious,the difference was statistically significant(P<0.05).After treatment,the oxygenation index of the two groups was higher than that before treatment,and the increase of the treatment group was more obvious(P<0.05);after treatment,APACHE II scores were decreased,and the decrease of the treatment group was more obvious,the difference was statistically significant(P<0.05).Conclusion Ulinastatin combined with CRRT is effective in the treatment of septic shock.