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乌司他丁对异位妊娠失血性休克患者肝肾功能的保护和对细胞因子的调节作用
引用本文:李智慧,白玉晶,林浩.乌司他丁对异位妊娠失血性休克患者肝肾功能的保护和对细胞因子的调节作用[J].中国急救复苏与灾害医学杂志,2008,3(9):544-547.
作者姓名:李智慧  白玉晶  林浩
作者单位:浙江省杭州市江干区彭埠镇社区卫生服务中心妇产科,310021
摘    要:目的探讨乌司他丁对异位妊娠失血性休克患者肝肾功能的保护和对细胞因子IL-6、IL-8、TNF-α的调节作用。方法将60例异位妊娠失血性休克的住院患者随机分为治疗组和对照组。两组病例入院后均予以输血、补液、抗休克及急诊开腹异位妊娠手术。治疗组在上述基础上,在术前或术中给予乌司他丁(广东天普生化医药公司生产)20万U加入100ml生理盐水静脉滴注;术后3d给予乌司他丁10万U加入100ml生理盐水静脉滴注,2次/d。观察两组患者围手术期平均动脉压(MAP)、心率(HR)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、血肌酐(Scr)、尿素氮(BUN)和白细胞介素6(IL-6)、白细胞介素8(IL-8)、肿瘤坏死因子α(TNF-α)的动态变化。结果两组患者围手术期MAP、HR变化无明显差异(P〉0.05)。两组患者术后ALT、AST、Scr、BUN均有不同程度的升高;与对照组比较,治疗组ALT、AST升高幅度明显较低(P〈0.05),恢复更快(P〈0.05);与对照组比较,治疗组Scr、BUN恢复亦明显要快(P〈0.05)。两组患者术后IL-6、IL-8含量均较术前明显升高(P〈0.05),但治疗组升高幅度明显低于对照组(P〈0.05),术后恢复明显快于对照组。两组患者术后TNF-α较术前均有升高;与对照组比较,治疗组TNF-α恢复明冠较快fP〈O.05)。结论乌司他丁对异位妊娠失血性休克患者的肝。肾功能有一定的保护作用,对细胞因子IL-6、IL-8和TNF-α的水平有一定的调节作用。

关 键 词:乌司他丁  异位妊娠  休克  肝肾功能  细胞因子

Protective effects of Ulinastatin on hepatorenal function in patients with hemorrhagic shock caused by ectopic pregnancy
LI zhi-hui,BAI yu-jing,LIN hao.Protective effects of Ulinastatin on hepatorenal function in patients with hemorrhagic shock caused by ectopic pregnancy[J].China Journal of Emergency Resuscitation and Disaster Medicine,2008,3(9):544-547.
Authors:LI zhi-hui  BAI yu-jing  LIN hao
Institution:. (Jianggan District Pengbu Community Health Center of Hangzhou City, Zhejiang Province, Hangzhou 310021,China)
Abstract:Objective To investigate the protective effects of Ulinastatin (UTI) on hepatorenal function in patients with hemorrhagic shock caused by ectopic pregnancy, and its regulatory effects on cytokines including IL-6, IL-8, and TNF-α. Methods 60 patients with hemorrhagic shock caused by ectopic pregnancy were randomly divided into a UTI group and a control group. They underwent transfusion, anti-shock therapy and emergency eetopic pregnancy surgery after admission. Moreover, the patients in the UTI group were given 200,000 units of intravenous UTI in 100 ml of saline either before or during surgery. Three days later, 100,000 units of intravenous UTI in 100 ml of saline was given Bid for three days. Before and during surgery, the mean arterial pressure (MAP), heart rate (HR), alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum creatinine (Scr), urea nitrogen (BUN), IL-6, IL-8, TNF-α were measured in both the UTI and control groups. Results There was no significant difference in the perioperative changes of MAP and HR between the UTI and control groups (P〉0.05), and the serum levels of ALT, AST, Ser and BUN increased in both the UTI and control groups after surgery. Compared with control group, the increase of ALT and AST in the UTI group were significantly lower (P〈0.05), with faster recovery (P〈0.05), and the recovery indexes of Scr and BUN were less than those in control group (P〈0.05). The postoperative IL-6, IL-8, TNF-α levels increased significantly in both groups (P〈0.05), although the increase was lower in the UTI group, with faster recovery (P〈0.05). Conclusion UTI has a protective effect on hepatorenal function in patients with hemorrhagic shock caused by ectopic pregnancy and has a regulatory effect on IL-6, IL-8 and TNF-α.
Keywords:Ulinastatin  Ectopic pregnancy  Shock  Hepatorenal function  Cytokines
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