本文關鍵詞：烏司他丁對全身炎癥反應綜合征的治療作用，由筆耕文化傳播整理發(fā)布。

烏司他丁對全身炎癥反應綜合征的治療作用

     邵義明 張良清 鄧烈華 姚華國

    【摘要】 目的: 探討烏司他丁在阻斷全身炎癥反應綜合征(SIRS)向多器官功能障礙綜合征(MODS)發(fā)展中的作用及其機制。方法 60例符合SIRS診斷標準3項以上的患者隨機分為試驗組(n=30)和對照組(n=30)，并選取15名正常體檢者作為正常組。試驗組接受常規(guī)抗感染治療，對照組在試驗組用藥基礎上靜脈注射烏司他丁100 kU，8 h 1次，連用5 d。常規(guī)監(jiān)測患者心率(HR)、呼吸頻率(RR)、體溫(T)、白細胞計數(shù)(WBC)、SIRS癥狀改善時間和病死率；并于治療前和治療后5 d抽取靜脈血檢測血清白細胞介素-6(IL-6)、IL-10、腫瘤壞死因子-α(TNF-α)、C反應蛋白(CRP)水平。正常組于體檢時抽血檢測的結(jié)果作為正常對照。結(jié)果: 試驗組T、RR、HR及WBC治療后改善情況均明顯優(yōu)于對照組(P<0.05或P<0.01)。SIRS患者入院時炎性細胞因子水平均明顯高于正常組(P均<0.01)；兩組患者治療后5 d的CRP、IL-6和TNF-α水平均較治療前明顯下降(P<0.05或P<0.01)，但試驗組下降較對照組更為明顯。試驗組治療后5 d的IL-10較治療前上升，治療前后自身對照差異有顯著性 (P<0.01)；對照組治療后5 d的IL-10水平與治療前比較差異無顯著性(P>0.05)。另外,試驗組患者治療后SIRS炎性指標超過3 d無明顯改善者明顯少于對照組(P<0.01)，，轉(zhuǎn)為MODS者較對照組明顯減少(10.00%比36.67%，P<0.05)，病死率也明顯減少(3.33%比20.00%，P<0.05)。結(jié)論: 烏司他丁可能通過上調(diào)抗炎因子和下調(diào)促炎因子，調(diào)控機體炎癥反應過程，從而阻斷SIRS向MODS的發(fā)展。

    【關鍵詞】 烏司他丁； 全身炎癥反應綜合征； C反應蛋白； 腫瘤壞死因子； 白細胞介素

    Clinical study on effects of ulinastatin on patients with systemic inflammatory response syndrome 

    SHAO Yi-ming, ZHANG Liang-qing, DENG Lie-hua, YAO Hua-guo.

    Department of Intensive Care Unit, Affiliated Hospital of Guangdong Medical College, Zhanjiang 524001， Guangdong, China

    【Abstract】 OBJECTIVE:To evaluate the value of ulinastatin in hindering systemic inflammatory response syndrome (SIRS) to proceed to multiple organ dysfunction syndrome (MODS). METHODS:Sixty patients were randomly divided into routine treatment group (n=30) and ulinastatin treatment group (n=30). Both groups were given routine treatment, while the patients of the ulinastatin treatment group were given ulinastatin (100 kU intraveneusly drip, once every 8 hours, and continued for 5 days) in addition. Additionally, 15 healthy persons were enrolled as normal control group. Temperature (T), heart rate (HR), respiration rate (RR) and white blood cell (WBC) count were observed everyday. The duration of SIRS, the number of organ dysfunction, and mortality were also compared. Serum C reactive protein(CRP), tumor necrosis factor-α (TNF-α), interleukin-6(IL-6) and IL-10 levels were measured before treatment and 5 days after in ulinastatin treatment group, routine treatment group, and in normal control group at the time of health examination. RESULTS:All of the SIRS markers were not different both in ulinastatin group and routine treatment group before treatment. T, RR, HR and WBC were reduced significantly after 3 days in ulinastatin group (P<0.05 or P<0.01), but HR was not lowered significantly after 5 days and WBC after 7 days of treatment in regular treatment group (P<0.05 or P<0.01). All of the cytokines in ulinastatin treatment group and routine treatment group were higher than normal control group before treatment. Serum CRP ......

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  本文關鍵詞：烏司他丁對全身炎癥反應綜合征的治療作用，由筆耕文化傳播整理發(fā)布。