摘要
目的 分析乌司他丁对脓毒症伴多器官衰竭血清中降钙素原（PCT）、C反应蛋白（CRP）及免疫功能的影响。方法 回顾性选取2014-03-2017-03贵阳市第二人民医院重症监护病房收治的脓毒症伴多器官衰竭患者157例，根据用药不同分为对照组和观察组。对照组患者采用常规治疗，观察组患者采用常规治疗联合乌司他丁治疗。观察两组患者治疗后APACHEⅡ评分、免疫功能指标、心功能指标、PCT、CRP、过氧化脂质（LPO）及单核细胞表面人类白细胞抗原DR位点（HLA-DR）水平变化情况。结果 两组患者治疗后APACHEⅡ评分均较治疗前改善，观察组患者治疗后APACHEⅡ评分优于对照组（P＜0.05）。治疗后，观察组患者PCT、CRP、LPO、BNP、HLA-DR、LVEF水平分别为（9.75±3.64）ng/mL、（9.11±3.91）mg/L、（4.10±1.69）EU/mL、（285.55±87.79）pg/mL、（26.94±4.02）%、（66.87±5.28）%；对照组分别为（9.87±3.55）ng/mL、（13.97±4.87）mg/L、（8.11±2.14）EU/mL、（311.01±95.25）pg/mL、（20.68±3.22）%、（55.48±6.34）%；两组患者治疗后CRP、LPO、BNP、HLA-DR、LVEF水平差异有统计学意义（P＜0.05），但PCT水平差异无统计学意义（P＞0.05）。观察组患者治疗后免疫功能指标水平均优于对照组（P＜0.05）。观察组患者1个月内病死率为18.29%,对照组为44.00%，差异有统计学意义（P＜0.05）。结论 乌司他丁辅助治疗脓毒症伴多器官衰竭疗效显著，可改善患者心功能，调节免疫指标水平，降低患者血清CRP和LPO水平，减少近期病死率。
Objective To analyze the effects of ulinastatin on serum procalcitonin （PCT）, C reactive protein （CRP） and immune function in patients with sepsis complicated with multiple organ failure. Methods From March 2014 to March 2017, 157 cases of sepsis with multiple organ failure in intensive care unit of Guiyang Second People＇s Hospital were retrospectively selected. According to drug use, it was divided into control group and observation group. The patients in the control group were treated with routine therapy, while the patients in the observation group were treated with routine therapy combined with ulinastatin. APACHE II the score, the mortality rate within 1 months, immune function, heart function index, PCT, CRP, lipid peroxide （LPO） and monocyte human leukocyte antigen DR （HLA -DR） level changes in the patientswere observed and analyzed between the two groups. Results APACHE 11 score of the two groups were improved compared with before treatment, patients in the observation group after treatment APACHE 11 score than the control group （P 〈 0.05）. After treatment, PCT, CRP, LPO, BNP, hla - dr and LVEF levels of the observation group were respectively （9.75 ± 3.64 4.02 2.14 ng/mL, （9.11±3.91） mg/L, （4. 10±1.69） EU/mL, （285.55 ±87.79） pg/mL, （26.94±4.02）% , （66.87±5.28） %; they were （9.87±3.55） ng/mL, （13.97±4.87） mg/L, （8.11 ±2.14） EU/mL, （311.01 ± 95.25 ） pg/mL, （20.68 ± 3.22） %, （55.48 ± 6.34） % , respectively in control group; there were statistically significant differences in CRP, LPO, BNP, hla- dr and LVEF levels between the two groups, but there was no statistical difference in PCT level （ P 〉 0.05 ）. The level of immune function in the observation group was better than that in the control group （ P 〈 0.05 ）. The mortality of the patients in the observation group was 18.29 in one month and that in the control group was 44.00. The fatality rate in the observation group was lower than that in the control group （
作者
张凯凯
于学忠
梁显泉
余姗姗
Zhang Kai -kai;Yu Xue -zhong;Liang Xian -quan;Yu Shah -shan(Guiyang Second People＇s Hospital, Guiyang 550023, Chin)
出处
《中国急救医学》
CAS
CSCD
北大核心
2018年第4期328-331,共4页
Chinese Journal of Critical Care Medicine
关键词
乌司他丁
脓毒症伴多器官衰竭
心功能
免疫功能
降钙素原
Ulinastatin
Sepsis complicated with multiple organ failure
Cardiac function
Immunity
Procalcitonin （PCT）
