乌司他丁对危重症患者凝血功能影响的临床研究

目的分析乌司他丁对危重症患者凝血功能影响的临床疗效。方法收集2010年1月至2012年6月期间我院重症监护病房的危重症患者共60例,所有患者入选时的APACHEⅡ评分>10分,排除原发性血液系统疾病、肿瘤、肝脏疾病及慢性器官功能不全患者。随机分为治疗组及对照组,对照组采用常规治疗,治疗组在常规治疗基础上加用乌司他丁20万U,q8h,共7天。于入选当时及第2、8天早7:00抽取静脉血,行PLT、PT、APTT、INR、Fib、D-D二聚体。于第7天行APACHEⅡ评分,记录ICU期间病死率。结果两组患者的年龄、性别组成及入组时APACHEⅡ评分无显著性差异(P>0.05),具有可比性。治疗组第2天和第8天的PLT、PT、APTT、INR、Fib和D-二聚体与第0天比较,明显改善(P<0.05),且与对照组同一时间点的组间比较,差异显著(P<0.05)。比较两组患者APACHEⅡ评分及ICU病死率,治疗组治疗后APACHEⅡ评分明显减低,且与对照组比较,差异显著(P<0.05);治疗组ICU病死率明显下降(P<0.05)。结论乌司他丁对危重症患者凝血功能改善有较好疗效,且能改善病情及降低病死率。

Clinical Study of Critically ill Patients Affected by the Coagulation by Ulinastatin

Objective To analyze the clinical efficacy of ulinastatin coagulation function in critically ill patients.Methods From January 2010 to June 2012,a total of 60 critically ill patients in the intensive care unit,who enrolled with APACHE Ⅱ score more than 10,excluding the primary blood system diseases,cancer,liver disease and chronic organ dysfunction patients.All patients were randomly divided into the treatment group or the control group.The patients in the control group were treated with conventional therapy,the treatment group was treated ulinastatin 200 000 u q8h on the basis of conventional therapy for 7 days.Venous blood was collected for PLT,PT,APTT and INR,Fib,the DD dimmer at 7：00 on the first,second and eighth day.APACHE Ⅱ scores on day 7,ICU mortality was recorded.Results Age,gender composition and into group APACHE Ⅱ score of the two groups was no significant difference（P0.05） and was comparable.In the treatment group,compared with the first day,PLT,PT,APTT and INR,Fib and D-dimer in the 2d and 8d,was significantly improved（P0.05） with the control group at the same time point.The difference was significant（P0.05）..After the treatment,APACHE Ⅱ score and ICU mortality of patients in the treatment group,was significant declined（P0.05）;ICU mortality in the treatment group decreased significantly（P0.05）.Conclusion ulinastatin improved coagulation function in critically ill patients has a good effect,and can improve the condition and reduce mortality.