乌司他丁辅助治疗脓毒症患儿外周血一氧化氮和诱导型一氧化氮合酶浓度变化的研究  

Effect of Ulinastatin on NO and iNOs Concentration in Peripheral Blood in Adjuvant Treatment of Sepsis in Children

作　　者：田先雨[1] 黄卫东[1] 韩再萍[1] 苏苓[1] 洪先欧[1] 张侃[1] 罗勇[1] 刘纯义[1] 

机构地区：[1]深圳市宝安区妇幼保健院,广东深圳518133

出　　处：《儿科药学杂志》2014年第3期1-3,共3页Journal of Pediatric Pharmacy

基　　金：2010年深圳市宝安区立项课题;项目编号:2010591

摘　　要：目的:观察乌司他丁辅助治疗脓毒症患儿外周血清中一氧化氮(NO)、诱导型一氧化氮合酶(iNOS)浓度的变化。方法:采用前瞻性、随机对照临床试验,收集我院2010年10月至2012年3月儿科重症监护病房符合脓毒症诊断标准的患儿60例,随机分为观察组和常规治疗组各30例,并选取健康儿童20例作为对照组。观察组在脓毒症常规治疗的基础上加用乌司他丁治疗,常规治疗组则只按照脓毒症常规疗法治疗。分别检测两组患儿入院时(基线)、药物干预3 d后外周血血清NO、iNOS水平,观察其水平变化,分析乌司他丁对脓毒症治疗的作用,并对脓毒症、严重脓毒症、脓毒性休克患儿进行分层研究。结果:对照组NO均值为(8.63±2.15)μmol/L,iNOS为(30.96±15.26)U/mL;脓毒症组入院时NO均值为(86.13±28.75)μmol/L,iNOS为(10.76±4.28)U/mL;严重脓毒症组入院时NO均值为(101.89±35.83)μmol/L,iNOS为(8.35±3.40)U/mL;脓毒性休克组入院时NO均值为(126.86±63.72)μmol/L,iNOS为(7.08±2.32)U/mL,组间比较差异有统计学意义(P<0.01)。不同严重程度的脓毒症比较,乌司他丁辅助治疗脓毒症及严重脓毒症患儿血清NO水平降低优于常规治疗组,iNOS上升水平也优于常规治疗组。结论:经乌司他丁干预3 d,脓毒症患儿外周NO水平明显下降,而iNOS水平有所上升。乌司他丁辅助治疗脓毒症,特别是一般脓毒症和严重脓毒症,可以抑制机体炎症反应,有助于控制炎症,值得临床早期应用及推广。Objective： To study the effect of ulinastatin as an adjuvant treatment on levels of NO and iNOS in peripheral blood in children with sepsis. Methods： A prospective, randomized controlled clinical trial method was adopted. Sixty cases of patients admitted to pediatric intensive care unit of Bao＇ an Maternal and Child Health Hospital of Shenzhen from October 2010 to March 2012 were divided into a routine treatment group and an observation group with 30 cases in each. At the same time, 20 cases were chosen as a normal control group. The observation group received ulinastatin combined with conventional treatment; the routine treatment group only received conventional treatment. Serum levels of NO and iNOS in peripheral blood were detected when patients were admitted to hospital and drug intervention for three days. The effect of ulinastatin in the treatment of sepsis was analyzed. At the same time, sepsis, severe sepsis and septic shock children were hierarchically researched. Results： The mean NO in the normal control group was （8.63±2. 15） umol/L, and iNOS was （30. 96 ± 15. 26） U/mL. The mean NO in the sepsis group was （86. 13 ± 28. 75 ） umol/L, and iNOS was （10.76±4.28） U/mL; in the severe sepsis group NO was （ 101.89±35.83 ） umol/L, and iNOS was （ 8.35 ±3.40） U/mL; in the septic shock group NO was （126.86±63.72） umol/L, and iNOS was （7.08±2.32） U/mL, there was statistically significant difference between the groups. The decline of NO and the increase of iNOS in the sepsis and severe sepsis group were greater than those in the routine treatment group. Conclusions： The NO levels in peripheral blood were significantly decreased and iNOS levels were increased in patients with sepsis and severe sepsis after ulinastatin intervention for three days. Ulinastatin may play a certain role in the inhibition of inflammatory reaction process and helping to control inflammation. It is worthy of clinical application and promotion timely.

关 键 词：乌司他丁 脓毒症 一氧化氮 诱导型一氧化氮合酶 

分 类 号：R720.5[医药卫生—儿科]