乌司他丁对严重烧伤患者肝肾功能和血清IL-6、IL-8以及IL-10水平的影响

目的探究乌司他丁对严重烧伤患者肝肾功能和血清白细胞介素-6(IL-6)、白细胞介素-8(IL-8)以及白细胞介素-10(IL-10)水平的影响。方法回顾性分析2009年1月~2013年1月本院烧伤科住院部收治的严重烧伤患者78例,根据治疗方式的不同,分为观察组(42例)和对照组(36例)。两组均给予补液抗休克、抗生素抗感染、创面处理、营养支持以及对症治疗等常规治疗,对照组给予0.9%Na Cl溶液500 ml静脉滴注,而观察组则给予乌司他丁300 KU治疗,即将乌司他丁300 KU溶于0.9%Na Cl溶液500 ml中,静脉滴注,2次/d,连续用药7 d。检测并比较两组患者治疗前和治疗3 d、7 d后的丙氨酸转移酶(ALT)、尿素氮(BUN)、血肌酐(SCr)以及血清IL-6、IL-8以及IL-10水平的变化,同时观察两组患者并发症的发生情况。结果治疗3 d、7 d后,观察组IL-6水平显著低于对照组,差异有统计学意义(165.51±26.28)vs(179.36±25.98),(43.67±6.76)vs(62.85±7.08),P<0.05];观察组IL-8水平显著低于对照组,差异有统计学意义(112.25±15.75)vs(128.54±20.26),(56.76±8.04)vs(64.48±7.41),P<0.05];而IL-10水平显著高于对照组,差异有统计学意义(28.24±6.12)vs(21.76±5.24),(9.54±2.04)vs(6.56±0.47),P<0.05]。结论乌司他丁抑制严重烧伤患者体内的炎症反应,可能是通过降低血清IL-6和IL-8水平,升高IL-10水平来实现的。乌司他丁亦可减轻严重烧伤患者肝、肾功能的损伤,安全有效。

Impact of IL-6,IL-8,IL-10 and hepatorenal function in patients with serious burn treated with ulinastatin

Objective To examine the impact on IL-6,IL-8,IL-10 and hepatorenal function in patients with serious burns that have been treated with ulinastatin. Methods Seventy-eight patients with serious burns who were admitted to the hospital from January 2009 to January 2013 were analyzed retrospectively. According to different treatment methods ,36 patients were assigned to a control group, and 42 patients were assigned to an observation group. The two groups were treated with conventional treatments for anti-shock,anti-infection,the management of burn wounds,nutritional support and symptomatic treatments. The control group was treated with 500 ml 0.9%NaCl,and the observation group was treated with 30 KU ulinastatin. The levels of ALT,BUN,SCr,IL-6,IL-8 and IL-10 were measured before and after treatment in the two groups. Results The levels of IL-6 were (165.51 ± 26.28) and (43.67 ± 6.76) in the observation group after treatment for 3 and 7 d, respectively;levels in the control group were (179.36 ± 25.98) and (62.85 ± 7.08), respectively,and the differences were statistically significant (P < 0.05);The levels of IL-8 were (112.25 ± 15.75) and (56.76 ± 8.04) in the observation group after treatment for 3 and 7 d, respectively;these values were notably lower than those in the control group,and the differences were statistically significant (P<0.05);The level of IL-10 were (28.24 ± 6.12) and (9.54 ± 2.04) in the observation group after treatment for 3 and 7 d, respectively;those in the control group were (21.76 ± 5.24) and (6.56 ± 0.47),respectively, and the differences were statistically significant (P<0.05). Conclusion The inhibition of inflammatory reaction in patients with serious burns by Ulinastatin might occur through lowering the levels of IL-6 and IL 8 and raising the levels of IL-10. Ulinastatin can reduce liver and kidney damage in patients with serious burns.