摘要
目的研究乌司他丁联合血液滤过治疗脓毒症患者的临床效果。方法选取2011年5月—2018年5月邯郸市中心医院收治的符合入选条件的脓毒症患者210例,将患者随机分为3组,对照组70例给予基础治疗,乌司他丁组70例给予基础治疗+乌司他治疗,联合治疗组70例给予基础治疗+乌司他丁+血液滤过治疗。观察3组治疗前及治疗96 h后的脏器功能损伤评分(SOFA评分、APACHEⅡ评分)变化情况,检测3组治疗前及治疗96 h后肝功能指标[丙氨酸转氨酶(ALT)、门冬氨酸转氨酶(AST)、总胆红素(TBil)、间接胆红素(IBil)]、肾功能指标[肌酐(Cr)、尿素氮(BUN)]、炎性指标[WBC计数、降钙素原(PCT)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素(IL-6)]水平。结果治疗96 h后,3组患者SOFA评分、APACHEⅡ评分及血清ALT、AST、TBil、IBil、Cr、BUN、WBC、PCT、CRP、TNF-α、IL-1β、IL-6水平均明显降低(P均<0.05);乌司他丁组和联合治疗组上述指标均明显低于对照组(P均<0.05),且联合治疗组均明显低于乌司他丁组(P均<0.05)。结论乌司他丁联合血液滤过治疗脓毒症可以明显减轻机体的炎症反应,改善脏器功能,治疗效果显著。
Objective It is to study the clinical effect of ulinastatin combined with hemofiltration in patients with sepsis.Methods 210 patients with sepsis who were admitted to Handan Central Hospital from May 2011 to May 2018 and met the inclusion criteria were randomly divided into 3 groups,70 patients in the control group were given basic treatment,70 cases in the ulinastatin group were given basic treatment+ulinastatin,and 70 patients in the combined treatment group were given basic treatment+ulinastatin+hemofiltration.The changes of organ function scores(SOFA score,APACHE II score)before treatment and after 96 hours of treatment in the three groups were observed,and the levels of liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBil),indirect bilirubin(IBil)],renal function indexes[creatinine(Cr),urea nitrogen(BUN)],inflammatory indexes[WBC count,procalcitonin(PCT),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin(IL-6)]before treatment and after 96 hours of treatment in the three groups were determined.Results After 96 hours of treatment,the SOFA scores,APACHEⅡscores and the levels of serum ALT,AST,TBil,IBil,Cr,BUN,WBC count,PCT,CRP,TNF-α,IL-1β,and IL-6 of the three groups were significantly reduced(P<0.05);the above indexes in the ulinastatin group and the combination treatment group were significantly lower than those in the control group(P<0.05),and the indexes in the combination treatment group were significantly lower than those in the ulinastatin group(P<0.05).Conclusion Ulinastatin combined with hemofiltration can prevent the body's inflammatory response,improve organ function,and have a significant therapeutic effect in the treatment of sepsis.
作者
祁卫华
王鑫
QI Weihua;WANG Xin(Hebei Central Hospital, Handan 056001, Hebei, China)
出处
《现代中西医结合杂志》
CAS
2020年第15期1631-1635,共5页
Modern Journal of Integrated Traditional Chinese and Western Medicine
关键词
脓毒症
炎性因子
乌司他丁
血液滤过
sepsis
inflammatory factors
ulinastatin
hemofiltration
