乌司他丁对烧伤患者炎症介质及血管内皮细胞影响的研究

目的：观察乌司他丁对烧伤患者炎症介质的影响及对血管内皮细胞的保护作用.方法：将30例烧伤患者随机分为对照组和乌司他丁组,选取健康者30例作为正常组.对照组患者给予液体复苏、抗生素、营养支持和手术等综合治疗.乌司他丁组给予综合治疗的同时,加用乌司他丁600 kU静滴,3次/d.两组患者分别在入院第1、3、7、14天用酶联免疫吸附法（ELISA）检测血中TNF-α、IL-6、血栓调节蛋白水平,用Percoll密度梯度离心法测定循环内皮细胞数量,并与正常组比较.结果：入院时对照组及乌司他丁组患者TNF-α、IL-6、血栓调节蛋白及循环内皮细胞数量显著高于正常组（P〈0.05）.乌司他丁组血栓调节蛋白、TNF-α、IL-6及循环内皮细胞数量在治疗第3、7天明显低于对照组（P〈0.05）;第14天乌司他丁组上述指标接近正常组,而对照组明显高于正常组（P〈0.05）.结论：乌司他丁能降低血中危重烧伤患者血清TNF-α、IL-6和血栓调节蛋白水平,对血管内皮细胞有保护作用.

Study on the effect of Ulinastatin on inflammatory mediator and vascular endothelium in burn patients

Objective：To study the effect of Ulinastatin on pro inflammatory mediators and the vascular endothe lial cells in burn patients. Methods：Thirty burn patients were randomly divided into 2 groups： control group and Ulinastatin group. Thirty healthy people were selected as normal group. In control group, patients were treated with fluid resuscitation, antibiotics, nutrition maintenance and operation etc. In Ulinastatin group, patients were treated with same treatments as the control group, but intravenous Ulinastatin 600 kU was given three times per day. Plasma tumor necrosis factor （TNF）-α, interleukin （IL）-6, thromhomodulin were measured with ELISA, and circulating endothelial cells as collected from plasma by centrifugation on a Percoll gradient were measured in all patients on admission, and on the 3rd, 7th, 14th day, respectively, and compared to those of the normal people. Results：Plasma levels of TNFα, IL-6, thrombomodulin and circulating endothelial ceils were markedly higher in control group and Ulinastatin group than those in normal group on admission （P〈0.05）. In Ulinastatin group, TNF-~, IL-6, thrombomodulin and circulating endothelial cells were significantly decreased compared to the con- trol group on the grd and 7th days （P〈0.05）, and reached the levels of normal group on the 14th day, but they were still higher in control group than those in normal group on the 14th day （P%0.05）. Furthermore, there was no difference in these values between Ulinastatin group and the normal group. Conclusions： Ulinastatin can de crease TNF-α, IL-6, thromhomodulin levels in plasma, and it has protective effect on the vascular endothelium in burn patients.