摘要
目的:探讨分子肝素联合乌司他丁治疗脓毒症的疗效以及对血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、IL-8、神经元特异性烯醇化酶(NSE)水平的影响。方法:选取收治的脓毒症患者82例作为研究对象,参照数字表法随机分为对照组和观察组均为41例。两组参见指南采取常规干预措施。观察组在对照组基础上给予低分子肝素,皮下注射,0.4~0.6 mL/次,2次/d;乌司他丁注射液静脉滴注, 3次/d。两组连续治疗1周。比较两组急性生理和慢性健康状况评分(APACHEⅡ)和Marshall评分、临床疗效以及血清TNF-α、IL-6、IL-8、NSE水平。结果:观察组治疗1周后APACHEⅡ和Marshall评分显著低于对照组,差异有统计学意义(P<0.01);观察组中脑电图(EEG)疗效总有效率(80.49%)显著高于对照组(58.54%),差异有统计学意义(P<0.05);观察组血清TNF-α、IL-6、IL-8、NSE水平显著低于对照组,差异有统计学意义(P<0.01)。结论:在常规治疗基础上,低分子肝素联合乌司他丁注射液治疗脓毒症可改善患者的症状体征,提高临床疗效,抑制炎性因子TNF-α、IL-6、IL-8、NSE水平可能与其疗效有关。
Objective To investigate the efficacy of low molecular weight heparin combined with Ulinastatin on serum levels of inflammatory factors tumor necrosis factor(TNF)-α,interleukin(IL)-6,IL-8,and neuron-specific enolase(NSE).Method 82 sepsis cases were selected as the subjective and randomly divided into the control group and the observation group with 41 cases in each group referring to randomized digital table.Both groups were treated with the routine therapy according to the guideline.Basis of the control group,the observation group was given with subcutaneous injection of low molecular weight heparin(0.4~0.6 ml/time and 2 times/day)and Ulinastatin(3 times/day).Scores of acute physiology and chronic health evaluationⅡ(APACHEⅡ)and Marshall,the efficacy,and serum levels of inflammatory factors TNF-α,IL-6,IL-8,and NSE were compared in both groups.Results After 1 week treatment,scores of APACHEⅡand Marshall in the observation group were obviously lower than the control group(P<0.01).The total effective rate of EEG in the observation group was 80.49%,which was obviously higher than control group(58.54%)(P<0.05).After 1 week treatment,serum levels of TNF-α,IL-6,IL-8,and NSE in the observation group were remarkably lower than those in the control group(P<0.01).Conclusion On basis of the routine therapy,low molecular weight heparin combined with Ulinastatin injection in treating sepsis can improve the symptoms and signs,increase the efficacy,and inhibiting of serum levels of inflammatory factors TNF-α,IL-6,IL-8 may be related with the efficacy.
作者
刘俊灵
樊雄辉
樊文浩
LIU Jun-ling;FAN Xiong-hui;FAN Wen-hao(Intensive Care Unit,Guangdong Provincial Armed Police Corps Hospital,Guangzhou 510507,China)
出处
《吉林医学》
CAS
2020年第3期550-553,共4页
Jilin Medical Journal
