目的:系统评价乌司他丁联合血必净治疗脓毒症患者的临床疗效。方法:计算机检索Cochrane library、Pub Med、中国生物医学文献数据库、中国知网、中文科技期刊全文数据库和万方数字化期刊全文数据库,查找有关乌司他丁联合血必净治疗脓毒...目的:系统评价乌司他丁联合血必净治疗脓毒症患者的临床疗效。方法:计算机检索Cochrane library、Pub Med、中国生物医学文献数据库、中国知网、中文科技期刊全文数据库和万方数字化期刊全文数据库,查找有关乌司他丁联合血必净治疗脓毒症患者临床疗效的随机对照试验,并追索纳入文献的参考文献,由2名评价者独立选择实验、提取资料和评估方法学质量,采用Rev Man 5.2软件进行Meta分析。结果:共纳入15项随机对照实验研究,共计1222例受试者(实验组509例,对照组713例)。Meta分析结果提示:与单用乌司他丁或血必净或仅使用常规方案治疗脓毒症病人相比,乌司他丁联用血必净能够明显减少患者病死率(RR=0.45,95%CI=0.35~0.59),降低患者7d的急性生理功能和慢性健康状况评分(acute physiology and chronic health evaluation,APACHEⅡ)(MD=-4.91,95%CI=-6.83^-2.98),缩短机械通气时间(MD=-7.33,95%CI=-10.16^-4.51)以及ICU住院时间(MD=-8.63,95%CI=-11.50^-5.76),且无明显不良反应发生。结论:乌司他丁与血必净联用优于单用二者之一或仅使用常规治疗方案,为脓毒症的治疗提供了新的治疗选择。展开更多
Summary: The changes of tumor necrosis factor-α (TNF-α) and brain ultrastructure during cardiopulmonary resuscitation and the effects of ulinastation injection were observed, and the mechanism was investigated. Twen...Summary: The changes of tumor necrosis factor-α (TNF-α) and brain ultrastructure during cardiopulmonary resuscitation and the effects of ulinastation injection were observed, and the mechanism was investigated. Twenty-four adult healthy Sprague-Dawley rats were randomly divided into control group (8 rats), resuscitation group (8 rats) and ulinastatin (UTI) group (8 rats). Rats in control group underwent tracheotomy without clipping the trachea to induce circulatory and respiratory standstill. Rats in resuscitation and ulinastatin group were subjected to the procedure of establishing the model of cardiopulmonary cerebral resuscitation (CPCR). Rats in ulinastatin group were given with UTI 104 U/kg once after CPCR. In the control group, the plasma was collected immediate, 30 min, 2 h, 4 h, and 6 h after tracheotomy. In resuscitation group and UTI group, plasma was collected immediate after tracheotomy, 30 min, 2 h, 4 h and 6 h after successful resuscitation. The plasma levels of TNF-α were determined by radioimmunoassay (RIA). At the end of the experiment, 2 rats were randomly selected from each group and were decapitated. The cortex of the brain was taken out immediately to observe the ultrastructure changes. In control group, there were no significant differences in the level of TNF-α among different time points (P>0.05). In resuscitation group, the level of TNF-α was increased obviously after resuscitation (P<0.01) and reached its peak 2 h later after resuscitation. An increasing trend of TNF-α showed in UTI group. There were no differences in TNF-α among each sample taken after successful resuscitation and that after tracheotomy. The utrastructure of brains showed the injury in UTI group was ameliorated as compared with that in resuscitation group. In early period of CPCR, TNF-α was expressed rapidly and kept increasing. It indicated that TNF-α might take part in the tissue injury after CPCR. The administration of UTI during CACR could depress TNF-α and ameliorate brain injury. By regulating the expres展开更多
目的:研究乌司他丁对缺血性脑血管病介入治疗患者血清S100B质量浓度及认知功能的影响,探讨乌司他丁对脑缺血患者的脑保护作用.方法:本研究为随机对照临床研究,选择拟在全麻下行介入治疗的缺血性脑血管病患者60例,性别不限,年龄40~65岁,B...目的:研究乌司他丁对缺血性脑血管病介入治疗患者血清S100B质量浓度及认知功能的影响,探讨乌司他丁对脑缺血患者的脑保护作用.方法:本研究为随机对照临床研究,选择拟在全麻下行介入治疗的缺血性脑血管病患者60例,性别不限,年龄40~65岁,BMI 20~30 kg/m^2,将其随机分为两组(n=30):乌司他丁组(U组)和对照组(C组).U组患者麻醉诱导前30 min给予乌司他丁10 000 U/kg(由生理盐水稀释至100 m L静脉滴注),C组患者在相同时间段静脉滴注100 m L生理盐水.于手术前及术后第1、3天行外周静脉采血,采用ELISA检测患者血清S100B质量浓度;同时在两组患者手术前及术后第1、3天,用MMSE评价其认知功能.结果:术后第1天和第3天,U组患者血清S100B质量浓度显著低于C组(P<0.05);同时,术后第1天,U组患者MMSE评分高于C组(P<0.05).结论:乌司他丁预处理可降低缺血性脑血管病介入治疗患者血清S100B质量浓度并改善患者术后早期认知功能,具有一定的脑保护作用.展开更多
目的观察乌司他丁（ulinastatin,UTI）对缺血性脑血管病介入治疗患者血清IL-1、IL-6含量及认知功能的影响，探讨UTI对脑缺血患者的脑保护作用。方法选择拟在全身麻醉下行介入治疗的缺血性脑血管病患者50例，年龄40-65岁，ASA分级Ⅰ、Ⅱ...目的观察乌司他丁（ulinastatin,UTI）对缺血性脑血管病介入治疗患者血清IL-1、IL-6含量及认知功能的影响，探讨UTI对脑缺血患者的脑保护作用。方法选择拟在全身麻醉下行介入治疗的缺血性脑血管病患者50例，年龄40-65岁，ASA分级Ⅰ、Ⅱ、Ⅲ级，BMI20-28kg／m2，采用随机数字表法分为两组（每组25例）：UTI（U组）和对照组（C组）。U组患者麻醉诱导前给予UTI 1万U／kg，术后第1、2、3天延用0．5万U／kg（均由生理盐水稀释至100ml静脉滴注）；C组患者在相同时间段静脉滴注100ml生理盐水。手术前和术后第1、3天行外周静脉采血，ELISA法检测患者血清IL-1、IL-6含量；同时用简易精神状态检查量表（mini-mental state exam，MMSE）评价两组患者术前和术后第1、3天的认知功能。结果U组患者血清IL-1、IL-6含量在术后第1天[（279±140）、（17±6）μg，L]和第3天[（204±83）、（14±4）μg／L]均显著低于c组[第1天（373±142）、（22±8）p．g／L；第3天（307±116）、（18±6）μg/L]，差异有统计学意义（P〈0．05）。U组患者MMSE评分在术后第1天[（28．5±1．0）分]显著高于c组[（27．9±1．2）分]，差异有统计学意义（P〈0．05）。结论UTI可降低缺血性脑血管病介入治疗患者血清IL-1、IL-6含量并改善患者早期术后认知功能。展开更多
文摘目的:系统评价乌司他丁联合血必净治疗脓毒症患者的临床疗效。方法:计算机检索Cochrane library、Pub Med、中国生物医学文献数据库、中国知网、中文科技期刊全文数据库和万方数字化期刊全文数据库,查找有关乌司他丁联合血必净治疗脓毒症患者临床疗效的随机对照试验,并追索纳入文献的参考文献,由2名评价者独立选择实验、提取资料和评估方法学质量,采用Rev Man 5.2软件进行Meta分析。结果:共纳入15项随机对照实验研究,共计1222例受试者(实验组509例,对照组713例)。Meta分析结果提示:与单用乌司他丁或血必净或仅使用常规方案治疗脓毒症病人相比,乌司他丁联用血必净能够明显减少患者病死率(RR=0.45,95%CI=0.35~0.59),降低患者7d的急性生理功能和慢性健康状况评分(acute physiology and chronic health evaluation,APACHEⅡ)(MD=-4.91,95%CI=-6.83^-2.98),缩短机械通气时间(MD=-7.33,95%CI=-10.16^-4.51)以及ICU住院时间(MD=-8.63,95%CI=-11.50^-5.76),且无明显不良反应发生。结论:乌司他丁与血必净联用优于单用二者之一或仅使用常规治疗方案,为脓毒症的治疗提供了新的治疗选择。
文摘Summary: The changes of tumor necrosis factor-α (TNF-α) and brain ultrastructure during cardiopulmonary resuscitation and the effects of ulinastation injection were observed, and the mechanism was investigated. Twenty-four adult healthy Sprague-Dawley rats were randomly divided into control group (8 rats), resuscitation group (8 rats) and ulinastatin (UTI) group (8 rats). Rats in control group underwent tracheotomy without clipping the trachea to induce circulatory and respiratory standstill. Rats in resuscitation and ulinastatin group were subjected to the procedure of establishing the model of cardiopulmonary cerebral resuscitation (CPCR). Rats in ulinastatin group were given with UTI 104 U/kg once after CPCR. In the control group, the plasma was collected immediate, 30 min, 2 h, 4 h, and 6 h after tracheotomy. In resuscitation group and UTI group, plasma was collected immediate after tracheotomy, 30 min, 2 h, 4 h and 6 h after successful resuscitation. The plasma levels of TNF-α were determined by radioimmunoassay (RIA). At the end of the experiment, 2 rats were randomly selected from each group and were decapitated. The cortex of the brain was taken out immediately to observe the ultrastructure changes. In control group, there were no significant differences in the level of TNF-α among different time points (P>0.05). In resuscitation group, the level of TNF-α was increased obviously after resuscitation (P<0.01) and reached its peak 2 h later after resuscitation. An increasing trend of TNF-α showed in UTI group. There were no differences in TNF-α among each sample taken after successful resuscitation and that after tracheotomy. The utrastructure of brains showed the injury in UTI group was ameliorated as compared with that in resuscitation group. In early period of CPCR, TNF-α was expressed rapidly and kept increasing. It indicated that TNF-α might take part in the tissue injury after CPCR. The administration of UTI during CACR could depress TNF-α and ameliorate brain injury. By regulating the expres
文摘目的:研究乌司他丁对缺血性脑血管病介入治疗患者血清S100B质量浓度及认知功能的影响,探讨乌司他丁对脑缺血患者的脑保护作用.方法:本研究为随机对照临床研究,选择拟在全麻下行介入治疗的缺血性脑血管病患者60例,性别不限,年龄40~65岁,BMI 20~30 kg/m^2,将其随机分为两组(n=30):乌司他丁组(U组)和对照组(C组).U组患者麻醉诱导前30 min给予乌司他丁10 000 U/kg(由生理盐水稀释至100 m L静脉滴注),C组患者在相同时间段静脉滴注100 m L生理盐水.于手术前及术后第1、3天行外周静脉采血,采用ELISA检测患者血清S100B质量浓度;同时在两组患者手术前及术后第1、3天,用MMSE评价其认知功能.结果:术后第1天和第3天,U组患者血清S100B质量浓度显著低于C组(P<0.05);同时,术后第1天,U组患者MMSE评分高于C组(P<0.05).结论:乌司他丁预处理可降低缺血性脑血管病介入治疗患者血清S100B质量浓度并改善患者术后早期认知功能,具有一定的脑保护作用.
文摘目的观察乌司他丁（ulinastatin,UTI）对缺血性脑血管病介入治疗患者血清IL-1、IL-6含量及认知功能的影响，探讨UTI对脑缺血患者的脑保护作用。方法选择拟在全身麻醉下行介入治疗的缺血性脑血管病患者50例，年龄40-65岁，ASA分级Ⅰ、Ⅱ、Ⅲ级，BMI20-28kg／m2，采用随机数字表法分为两组（每组25例）：UTI（U组）和对照组（C组）。U组患者麻醉诱导前给予UTI 1万U／kg，术后第1、2、3天延用0．5万U／kg（均由生理盐水稀释至100ml静脉滴注）；C组患者在相同时间段静脉滴注100ml生理盐水。手术前和术后第1、3天行外周静脉采血，ELISA法检测患者血清IL-1、IL-6含量；同时用简易精神状态检查量表（mini-mental state exam，MMSE）评价两组患者术前和术后第1、3天的认知功能。结果U组患者血清IL-1、IL-6含量在术后第1天[（279±140）、（17±6）μg，L]和第3天[（204±83）、（14±4）μg／L]均显著低于c组[第1天（373±142）、（22±8）p．g／L；第3天（307±116）、（18±6）μg/L]，差异有统计学意义（P〈0．05）。U组患者MMSE评分在术后第1天[（28．5±1．0）分]显著高于c组[（27．9±1．2）分]，差异有统计学意义（P〈0．05）。结论UTI可降低缺血性脑血管病介入治疗患者血清IL-1、IL-6含量并改善患者早期术后认知功能。
