乌司他丁改善严重脓毒症患者器官功能的前瞻性随机对照研究  

A prospective randomized controlled study of Ulinastatin in improving organ function in patients with severe sepsis

作　　者：黎文研[1] 周立新[1] 誉铁鸥[1] 方滨[1] 温伟标[1] 强新华[1] 黎昌[1] 余志辉[1] 

机构地区：[1]广东省佛山市第一人民医院ICU,广东佛山528000

出　　处：《中国医药导报》2013年第35期106-108,共3页China Medical Herald

摘　　要：目的 研究乌司他丁对严重脓毒症患者循环功能的影响.方法 选择2010年10月～2012年12月收住佛山市第一人民医院ICU的18岁以上严重脓毒症患者,将其分为乌司他丁治疗组和对照组.对照组采用经典脓毒症常规治疗,乌司他丁治疗组在经典脓毒症常规治疗基础上加用乌司他丁[1万～2万U/（kg·d）],观察两组患者治疗前后器官功能指标和序贯器官衰竭估计（SOFA）评分的变化.结果 与对照组同期比较,乌司他丁治疗组治疗后24 h动脉血乳酸明显降低,治疗后72 h舒张压明显升高（P＜0.05）.乌司他丁治疗组治疗后3d谷丙转氨酶（ALT）、谷草转氨酶（AST）明显低于对照组同期（P＜0.05）;治疗后3d和7d血肌酐和SOFA评分亦低于对照组同期,氧合指数高于对照组同期,但差异无统计学意义（P＞0.05）.结论 乌司他丁治疗可以明显改善严重脓毒症患者的循环功能和肝脏功能,对肺和肾脏功能也可能具有保护作用.Objective To investigate the effects of Ulinastatin for circulatory function of patients with severe sepsis.Methods Severe sepsis patients over 18 years old admitted to the ICU in the First People＇s Hospital of Foshan City from October 2010 to December 2012 were selected and divided into Ulinastatin treatment group and control group.The patients in the control group were treated with classical SSC therapy,the patients in the treatment group were treated with the Ulinastatin [10 000-20 000 U/（kg· d）].The changes of organ function and SOFA score were recorded before and after treatment.Results Compared to the control group,the arterial lactate of treatment group was significantly lower after treatment for 24 h,and diastolic blood pressure was significantly increased after treatment for 72 h （P 〈 0.05）.After treatment for 3 d,the levels of ALT and AST of Ulinastatin treatment group were significantly lower than those of the control group （P 〈 0.05）; after treatment for 3 d and 7 d,serum creatinine and SOFA score was lower than the control group over the same period,oxygenation index was higher,but the differences were not statistically significant （P 〉 0.05）.Conclusion Ulinastatin therapy can effectively improve the circulatory function and liver function in patients with severe sepsis.Ulinastatin therapy may also have a protective effective on the lung and kidney function.

关 键 词：乌司他丁 严重脓毒症 器官功能 随机对照试验 

分 类 号：R572[医药卫生—消化系统]