摘要
目的通过乌司他丁治疗重症烧伤脓毒症患者的疗效观察,探讨其中的可能机制。方法将62例重症烧伤脓毒症患者随机分为治疗组(n=31)和对照组(n=31),对照组采取经典治疗方案,包括早期复苏,抗感染治疗,营养支持对症治疗,血液净化治疗及呼吸机治疗等,治疗组在经典治疗的基础上加用乌司他丁治疗,观察比较两组治疗前后呼吸(R)、心率(HR)、体温(T)、白细胞计数(WBC)及中性粒细胞比例(N)等临床指标和动静脉血气分析、肌酐(Cr)、尿素氮(BUN)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶同工酶MB(CK-MB)等血液生化指标的变化。同时比较两组28 d病死率。结果治疗后两组患者R、HR、T、WBC及中性粒细胞比例较前明显下降(P<0.05),两组患者血浆ALT、AST、Cr、BUN、LDH、CK-MB均下降,治疗组各指标改善更加明显(P<0.05),两组机体摄氧率及氧合指数增加(P<0.05),治疗组增加更加显著(P<0.05),与对照组相比28 d病死率明显下降(P<0.05)。结论乌司他丁可有效抑制重症烧伤脓毒症患者的炎症反应,改善患者器官功能及机体摄氧功能,具有良好的临床效果。
Aim To analyze the efficiency of ulinastatin（UTI）in patients with severe burn sepsis syndrome.Methods 62 patients with severe burn sepsis syndrome were randomly divided into treatment group（n=31）and control group（n=31）.In the treatment group,patients had Ulinastatin 400 000 IU twice every day for 7 days.The classical treatment including early resuscitation,antibiotic therapy,mechanical ventilation therapy and blood purification was given to two groups.Temperature,respiration,heart rate and white blood cell,neutrocyte percent,the mortality rate on 28 days and other plasma biochemistry indexes were determined before the treatment and after the treatment.Results After the treatment,the levels of temperature,respiration,heart rate and white blood cell,neutrocyte percent were significantly decreased in two groups（P〈0.05）,but the decreases of the treatment group were more marked（P〈0.05）,The ratio and index of oxygen increased.Plasma alanine amino transferase,aspartate amino transferase,blood ureanitrogen,lactate dehydrogenase and MB isoenzyme of creatine kinase were decreased in two groups after the treatment（P〈0.05）,but the decreases of all these plasma biochemistria indexes were more marked in UTI group（P〈0.05）.The treatment group has lower mortality rate on 28 days（P〈0.05）.Conclusion UTI has beneficial effects in patients with severe burn sepsis syndrome.
出处
《安徽医药》
CAS
2010年第11期1340-1342,共3页
Anhui Medical and Pharmaceutical Journal
基金
2009年安徽省卫生厅科研资金资助(No09A067)
