乌司他丁对严重脓毒症患者脑钠肽与脉波轮廓温度稀释连续心排血量监测技术监测指标的影响  

The effect of iflinastatin on NT -proB- NP and Picco in patients with severe sepsis

作　　者：明自强[1] 俞林明[1] 

机构地区：[1]浙江省新昌县人民医院ICU,312500

出　　处：《中国基层医药》2016年第3期435-438,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨乌司他丁（Ulinastatin，UTU对严重脓毒症（SevereSepsis，SS）患者脑钠肽与脉波轮廓温度稀释连续心排血量监测技术（PICCO）监测指标的影响。方法将50例重症监护室（icu）SS患者按随机数字表法分为对照组和观察组，每组25例。对照组给予脓毒症一般治疗，观察组在对照组基础上加用UTI。两组均给予Piceo监测，分别在入ICU后治疗前和治疗后第7天抽静脉血，测心肌肌钙蛋白（cTnI）、B．型钠尿肽前体（NT—proB—NP）、肿瘤坏死因子-α（TNF-α）指标变化，抽动脉血测乳酸（Lac）的变化，同时记录两组患者Picco监测指标心功能指数（CFI）、APACHEU评分）的变化。结果两组治疗前CFI、cTnI、NT-proBNP差异均无统计学意义（t=0．419、0．321、0．335，均P〉0．05），与对照组比较，治疗后观察组cTnl和NT—pmBNP下降更明显（t=2．976、2．910，均P〈0．05），而CFI提升更为明显[（3．98±0．95）与（2．39±0．85），t=6．237，P〈0．05]；两组治疗前TNF-α和Lac差异均无统计学意义（t=0．602、0．848，均P〉0．05），与对照组比较，治疗后观察组TNF-伐和Lae下降明显更快（t=8．478、3．104，均P〈0．05）；与对照组比较，观察组治疗后APACHEⅡ评分下降明显（t=2．321．P〈0．05）。结论UTI治疗可以降低SS患者的NT-proBNP及炎性细胞因子，改善心功能。Objective To observe the effect of ulinastatin on NT - proB - NP and Picco in patients with severe sepsis. Methods 50 patients with severe sepsis wei＇e randomly divided into the control group and observation group ,25 patients in each group. The control group received the routine treatment, and the observation group received ulinastatin additionally. The venous blood was collected to determine cTn - I, NT - proBNP, TNF - a and Lac before treatment and 7 days after treatment. The APACHE IT and CFI were observed before treatment and 7 days after treat- ment. Results The differences of CFI, eTnI, NT - proBNP in the two groups before treatment were not significant （ t = 0.419,0. 321, 0. 335, all P 〉 0.05 ）, after treatment, cTnI and NT - proBNP decreased more significantly （ t = 2. 976,2. 910,all P〈O. 05） ,while lifting more apparent CFI[ （3.98 ±0.95） vs. （2.39 ±0.85） ,t =6. 237,P 〈0. 05 ] in the observation group than in the control group. The differences of TNF - α and Lac in the two groups before treatment were not significant （ t = 0. 602, 0. 848, all P 〉 0. 05 ）, after treatment, TNF -α and Lac decreased signiflcatatly faster in the observation group than in the control group （ t = 8. 478,3. 104, all P 〈 0.05 ）. After treat- ment, APACHE 1T score decreased significantly in observation group than in the control group（ t = 2. 321, P 〈 0.05 ）. Conclusion Ulinastatin had protective effects on heart function in patients with severe sepsis.

关 键 词：脓毒症 利钠肽 脑 乌司他丁 

分 类 号：R459.7[医药卫生—急诊医学]