乌斯他汀注射剂联合血必净注射液治疗脓毒症的临床研究  

Clinical trial of ulinastatin injection combined with Xuebijing injection in the treatment of sepsis

作　　者：王丽萍[1] 王大明[1] 吴松[1] 孙丹[1] WANG Li - ping;WANG Da - ming;WU Song;SUN Dan(Department of Emergency, First People＇s Hospital of Changzhou City, Changzhou 213000, Jiangsu Province, China)

机构地区：[1]常州市第一人民医院急诊科,江苏常州213000

出　　处：《中国临床药理学杂志》2018年第11期1309-1311,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察乌斯他汀注射剂联合血必净注射液治疗脓毒症的临床疗效及安全性。方法将137例脓毒症患者随机分为对照组68例和试验组69例。对照组予以血必净每次50 m L,q12 h,静脉滴注;试验组在对照组治疗的基础上,予以乌司他汀每次1.0×10~4U,q12 h,静脉滴注。2组患者均连续治疗7 d。比较2组患者的临床疗效、Toll样受体-2(TLR-2)mRNA和TLR-4 mRNA,肿瘤坏死因子-α(TNF-α)、白细胞介素^(-1)β(IL^(-1)β)和IL-6水平,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为88.41%(61例/69例)和83.82%(57例/68例),差异无统计学意义(P>0.05)。治疗后,试验组和对照组的TLR-2 mRNA分别为(0.22±0.07)和(0.28±0.06),TLR-4 mRNA分别为(0.19±0.05)和(0.32±0.05),TNF-α分别为(23.58±3.57)和(28.67±3.22)μg·L^(-1),IL^(-1)β分别为(27.28±4.67)和(38.67±5.34)μg·L^(-1),IL-6分别为(16.57±4.25)和(29.24±4.85)μg·L^(-1),差异均有统计学意义(均P<0.05)。2组患者的药物不良反应均以胃肠道反应和皮疹为主,试验组和对照组的总药物不良反应发生率分别为4.35%和5.88%,差异无统计学意义(P>0.05)。结论乌斯他汀注射剂联合血必净注射液虽然不能显著提高治疗脓毒症的临床疗效,但其能显著降低TLRs表达和炎症因子水平,且不增加药物不良反应的发生率。Objective To observe the efficacy and safety of ulinastatin injection combined with Xuebijing injection in the treatment of sepsis.Methods A total of 137 patients with sepsis were randomly divided into control group（ n = 68 cases） and treatment group（ n = 69 cases）.Control group was treated with Xuebijing 50 m L per time,q12 h,intravenous drip. Treatment group was given ulinastatin 1. 0 × 10~4 U per time,q12 h,intravenous drip,on the basis of control group. Two groups were treated for 7 d. The effective rate,TLR-2 and TLR-4 mRNA expression level,tumor necrosis factor α（ TNF-α）,interleukin 1β（ IL^（-1）β） and interleukin 6（ IL-6） level,and adverse drug reactions were compared between two groups. Results After treatment,the effective rates of the treatment group and the control group were 88. 41%（ 61 cases/69 cases） and 83. 82%（ 57 cases/68 cases） without significant difference（ P〈0. 05）. After treatment,the main indexes in treatment and control groups were compared： the TLR-2 mRNA were（ 0. 22 ± 0. 07） and（ 0. 28 ± 0. 06）,TLR-2 mRNA were（ 0. 19 ± 0. 05） and（ 0. 32 ± 0. 05）,the TNF-α were（ 23. 58 ± 3. 57） and（ 28. 67 ± 3. 22） μg·L^（-1）,the IL^（-1）βwere（ 27. 28 ± 4. 67） and（ 38. 67 ± 5. 34） μg · L^（-1）,the IL-6 were（ 16. 57 ± 4. 25） and（ 29. 24 ± 4. 85）μg·L^（-1）,the differences were statistically significant（ all P〈0. 05）. The adverse drug reactions were gastrointestinal reactions and rash. The total incidences of adverse drug reaction rates in treatment and control groups were 4. 35% and5. 88% without significant difference（ P〉0. 05）. Conclusion Ulinastatin injection combined with Xuebijing injection can not significantly improve the clinical efficacy in the treatment of sepsis,but it can significantly reduce the expression of TLRs and inflammatory factors,without increasing the incidence of adverse drug reactions.

关 键 词：乌司他汀注射剂 血必净注射液 脓毒症 安全性 

分 类 号：R97[医药卫生—药品]