乌司他丁联合血必净注射液治疗脓毒症的临床疗效及对炎性因子的影响

目的：探讨乌司他丁联合血必净对脓毒症的临床疗效及炎性因子的影响。方法选择2013年12月至2015年2月上海交通大学医学院附属新华医院收治的脓毒症患者76例，依据随机数字表法分为对照组和观察组，各38例。对照组在常规治疗基础上加用血必净30 mL ，加至0．9％ NaCl溶液10 mL ，静脉滴注，每日1次，连续使用1周；观察组在对照组治疗的基础上使用乌司他丁10万U ，加至0．9％ NaCl溶液50 mL ，静脉滴注，每日2次，连续使用1周。比较两组患者的治疗效果。结果治疗后，观察组总有效率显著高于对照组，差异有统计学意义[94．7％（36／38）比57．9％（22／38），P＜0．05]，且观察组患者的肿瘤坏死因子（TNF）-α（86±26） ng／L、白细胞介素（IL）-6（26±8） ng／L、IL-8（26±13） ng／L、C-反应蛋白（CRP）（26±3） mg／L、降钙素原（PCT ）（0．83±0．23）μg／L、内毒素（2．2±0．9）μg／L等指标以及急性生理学及慢性健康状况评分系统Ⅱ（APACH-Ⅱ评分）（15±5）均明显少于对照组患者[（119±24） ng ／L、（60±7） ng ／L、（50±12） ng ／L、（78±7） mg ／L、（2．84±1．18）μg／L、（3．9±1．0）μg／L、（20±5）分]，差异有统计学意义（ P＜0．05）；机械通气时间（11±4）d、重症监护病房住院时间（13±3）d等也较对照组患者（14±3）d、（18±4）d有明显缩短，差异有统计学意义（ P＜0．05）。结论乌司他丁联合血必净可有效降低脓毒症患者的炎性因子水平，保护患者的脏器功能，降低患者的APACH-Ⅱ评分，缩短患者住院时间，提高患者的生活质量，值得临床应用。

Effects of Ulinastatin Plus Xuebijing Injection on Inflammatory Factors in Patients with Sepsis

Objective To investigate the effects and inflammatory factors of Ulinastatin plus Xuebijing Injection for treatment of sepsis .Methods 76 patients with sepsis were included in Shanghai Jiaotong University School of Medicine Affiliated Xinhua Hospi-tal from December 2013 toFebruary 2015 were randomly devided into the control group and the observation group ,38 patients in each group .Patients in the control group were treated with Xuebijing 30 mL + 0 .9% NaCl 10 mL based on the conventional treat-ment ,intravenous infusion once daily ,and continuous use for one week .Patients in the observation group were treated with Ukraini-an pentostatin 100 ,000 U + 0 .9% NaCl 50 mL on the basis of the control group ,intravenous infusion twice a day ,and continuous use for one week .The treatment effect between the two groups was compared .Results After treatment ,the total effective rate of the patients in the observation group was significantly higher than the patients in the control group [94 .7% (36/38) vs57 .9% (22/38)] ,a statistically significant difference between groups (P<0 .05) ,and other observed index of patients in the observation group TNF-α(86 ± 26) ng/L ,IL-6(26 ± 8) ng/L ,IL-8(26 ± 13) ng/L ,CRP(26 ± 3) mg/L ,PCT (0 .83 ± 0 .23)μg/L ,LPS(2 .2 ± 0 .9)μg/L ,APACH-Ⅱ(15 ± 5) scores were significant lower than patients in the control group ,[(119 ± 24) ng/L ,(60 ± 7) ng/L ,(50 ± 12) ng/L ,(78 ± 7) mg / L ,(2 .84 ± 1 .18)μg/L ,(3 .9 ± 1 .0)μg/L ,(20 ± 5) scores] ,a statistically significant difference between groups .Moreover ,duration of mechanical ventilation and ICU length of stay of patients in the observation group were (11 ± 4)d and (13 ± 3)d ,which were also lower than the control group (14 ± 3)d and (18 ± 4)d ,a statistically significant difference between groups (P<0 .05) .Conclusion UTI plus Xuebijing can effectively reduce levels of inflammatory cytokines in patients with sepsis , protecting organ function in patients and reduce the patient′s APACH-Ⅱ score ,and it is worthy of applications .