摘要
目的:探讨乌司他丁对重症监护病房(ICU)脓毒症患者凝血功能障碍的影响及其机制。方法:选择64例ICU脓毒症患者,按随机数字表法分成治疗组和对照组,各32例。对照组患者采用常规治疗,治疗组患者在对照组治疗的基础上加用乌司他丁注射液,每次取10万单位溶于500 ml 15%葡萄糖注射液或氯化钠注射液中静脉滴注,每日3次,连用7 d。统计两组患者的机械通气时间、ICU住院时间和30 d生存率;检测患者治疗前与治疗后第1、3、7天的血小板计数(PLT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)、白细胞计数(WBC)和白细胞介素-6(IL-6)水平。结果:治疗后,治疗组患者的机械通气时间、ICU住院时间显著短于对照组,生存率显著高于对照组,差异有统计学意义(P<0.05);治疗组外周血中的WBC和IL-6水平显著低于对照组,差异有统计学意义(P<0.05);治疗组治疗后第7天的各凝血指标水平与治疗前和治疗后对照组比较,差异均有统计学意义(P<0.05),各项凝血指标在治疗后7 d恢复至正常水平。结论:乌司他丁可改善ICU脓毒症患者的凝血功能,其作用机制可能与乌司他丁抑制炎性因子的释放及相应的凝血因子功能有关。
OBJECTIVE：To explore the effect and mechanism of ulinastatin on blood coagulation dysfunction of ICU sepsis patients. METHODS：64 ICU sepsis patients were randomly divided into treatment and control groups,with 32 cases in each group.Control group received routine treatment,while treatment group was additionally given Ulinastatin injection on the basis of control group,100 000 u dissolved in 500 ml 15% Glucose injection or Sodium chloride injection intraveously,3 times/d,for consecutive 7days. The mechanical ventilation time,ICU length of stay and survival rate within 30 d were analyzed statistically in 2 groups. The platelet count（PLT）,prothrombin time（PT）,activated partial thromboplastin time（APTT）,fibrinogen（FIB）,D-dimer（D-D）,white blood cell count（WBC） and IL-6 were detected before treatment and on first,third and seventh day after treatment. RESULTS：After treatment,mechanical ventilation and ICU length of stay in treatment group were significantly shorter than in control group,and survival rate was significantly higher than control group,with statistical significance（P〈0.05）. The peripheral blood WBC and IL-6 level of treatment group were significantly lower than those of control group,with statistical significance（P〈0.05）.There was a significant difference in blood coagulation indicators between treatment group after 7 days of treatment and before treatment,control group after treatment（P〈0.05）. The blood coagulation indicators recovered to normal level after 7 days of treatment.CONCLUSIONS：Ulinastatin can improve blood coagulation of ICU sepsis patients by a mechanism of inhibiting the release of inflammatory cytokines and corresponding blood coagulation factor function.
出处
《中国药房》
CAS
北大核心
2015年第29期4094-4096,共3页
China Pharmacy
基金
浙江省医药卫生科技计划项目(No.2009B171)
