乌司他丁对外伤性脓毒症脏器保护及全身炎症反应的抑制作用

目的 探讨乌司他丁（Ulinastatin,UTI）对严重外伤后脓毒症的重要脏器功能保护及全身炎症反应的抑制作用.方法 选择42例严重外伤后脓毒症患者,随机分为对照组和UTI治疗组.对照组常规给予抗炎、抗休克补液治疗,UTI组则在对照组的基础上加用UTI治疗,连续3 d.各组分别于入院第0天,入院第1、2、3天测定动脉血气分析、血常规及临床生化指标,结果与对照组的组间比较,UTI治疗组的外周血中C反应蛋白、白细胞总数显著下降（P〈0.05或P〈0.01）,患者的心率、呼吸频率显著改善（P〈0.05）,严重外伤后经过UTI治疗3d,患者的心肌酶学、肝功能及肾功能指标显著改善,其中AST、ALT、BUN、Cr、LDH及CK指标,与入院0天比较均有显著性差异（P〈0.05或P〈0.01）.与对照组比较,UTI治疗组的心肌酶谱CK、肾功能的Cr与BUN、肝功能的ALT、AST指标均有显著性差异（P〈0.05或P〈0.01）,而LDH、CK-MB则没有显著性差异（P〉0.05）.结论 UTI能有效降低严重外伤后脓毒症患者的脏器功能受损及抑制全身炎症反应综合征.

Effect of Ulinastatin on organ protection and systemic inflammatory response in sepsis post severe trauma

Objective To explore the suppression effect of ulinastain（UTI） on organ protection and systemic inflammatory response in sepsis post severe trauma. Methods 42 cases of sepsis post trauma were randomly divided into control group and the UTI group. The control group was given conventional anti-shock, anti-inflammatory and anti-infection while the UTI group was given UTI treatment for 3 days on top of the treatments given to control group. Arterial blood gas analysis, a full blood count, and clinical biochemical markers were performed in the consecutive three days. Results Comparing with control group, C reactive protein and WBC in peripheral blood in UTI group decreased significantly （P〈O.05 or P〈O.O1）; the heart beat and respiratory rate improved significantly （P〈0.05）. Upon the three-day UTI treatment, serum creatine kinase, liver function and renal function markers improved significantly, including AST, ALT, BUN, Cr, LDH and CK markers （P〈0.05 or P〈0.01）. Conclusion UTI is considered being effective in reducing the damage caused by organ function and inhibition of systemic inflammatory response syndrome in sepsis post severe trauma.