乌司他丁对严重脓毒症致急性呼吸窘迫综合征患者血浆C反应蛋白、降钙素原及乳酸水平的影响  

The impact of Ulinastatin injection in patients′ plasma levels of CRP, PCT and lactate in ARDS patients with severe sepsis

作　　者：黄增相[1] 陶骅[1] 徐雯[1] 徐迅科[1] 金姝[1] 张健[1] 魏建东[1] 何超[2] 李文放[2] 林兆奋[2] 

机构地区：[1]上海市普陀区人民医院急诊科,200060 [2]上海第二军医大学附属长征医院急救科,200003

出　　处：《实用医学杂志》2015年第10期1692-1694,共3页The Journal of Practical Medicine

基　　金：上海市普陀区卫生系统自主创新科研项目资助(编号:普KW12305)

摘　　要：目的:探讨乌司他丁注射液(UTI)干预前后,严重脓毒症性急性呼吸窘迫综合征(ARDS)患者血浆降钙素原(PCT)、C反应蛋白(CRP)和乳酸水平的变化和意义。方法:选择58例符合严重脓毒症性ARDS诊断标准的患者作为研究对象,随机分为UTI治疗组和对照组,通过胸阻抗法(TEB)测定SV、氧合指数(Pa O2/Fi O2),观察两组患者治疗前后血浆PCT、CRP和乳酸水平、SV、Pa O2/Fi O2、Murray肺损伤评分、急性生理和慢性健康(APACHE II)评分、SOFA评分以及28 d死亡率。结果:与对照组相比,UTI治疗组患者Pa O2/Fi O2显著升高(P<0.05),血浆PCT、CRP和乳酸水平下降明显以及28 d死亡率显著降低(P<0.05)。结论:在常规治疗基础上UTI注射液能够降低严重脓毒症性ARDS患者血浆PCT、CRP的浓度,降低乳酸水平,改善临床症状,降低28Objective To compare the differences between patients＇ plasma levels of PCT, CRP and lactate before and after the intervention of Ulinastin. Methods Fifty-eight cases of severe sepsis criteria for the diagnosis of ARDS patients were chosen as the research objects. Patients were randomly divided into UTI treatment group and control group. TEB was applied to test SV and PaOJFiO〉 Plasma PCT, CRP, lactate levels, SV, PaO2/FiO2, Murray lung injury score, acute physical and chronic health score, sepsis related organ failure assessment score and the 28 day mortality rate before and after the treatments were observed. Results There were significant increase in PaO2/FiO2 in the treatment group than the control group （P 〈 0.05）. The plasma PCT, CRP and lactate levels decreased obviously and the 28 day mortality significantly decreased （P 〈 0.05）. Conclusions Conventional therapy combined with UTI injection can reduce ARDS plasma PCT, CRP and lactic acid level on severe sepsis patients. In addition, the clinical symptoms can be improved, and 28 day mortality can be reduced.

关 键 词：呼吸窘迫综合征 成人 脓毒症 PCT CRP 乳酸 UTI 

分 类 号：R459.7[医药卫生—急诊医学]