乌司他丁对心肺复苏后心肌功能障碍患者的保护作用的临床研究

目的：探讨乌司他丁对心肺复苏后心肌功能障碍的保护作用。方法将成人心肺复苏自主循环恢复后的患者33例随机分为对照组（16例）按常规治疗，治疗组（17例）在常规心肺复苏综合治疗基础上加用乌司他丁20万单位静脉推注，每12 h推注1次，5 d为1个疗程。记录治疗前及治疗后12、24、72 h患者的血乳酸、心肌肌钙蛋白（ cTnI）及B型利钠肽（ BNP）水平并计算12、24、72 h患者的血乳酸清除率。结果乌司他丁治疗组患者cTnI，治疗后72h较对照组差异有统计学意义（ P＜0．05），BNP高峰（24 h）明显下降（P＜0．05）。24、72 h乳酸清除率升高（P＜0．05），组织灌注改善，住院天数缩短，病死率下降（P＜0．05）。结论乌司他丁能改善心肺复苏术后患者的组织灌注、对心肌功能障碍有一定保护作用，对该类患者预后有积极影响。

Clinical study of ulinastatin has protective effects on myocardial dysfunction in patients after cardiopulmonary resuscitation

Objective to investigate the protective effects of ulinastatin on myocardialdysfunction after cardiopulmonary resuscitation . Methods The adult cardiopulmonary resuscitation （ CPR） of spontaneous circulation recovery after 33 patients were randomly divided into control group（16 cases） by conventional treatment,the treatment group（17 cases） based on conventional cardiopulmonary resusci-tation（CPR） comprehensive treatment combined with ulinastatin 200000 units of intravenous injection,once every 12 h push note 1,5 d for a course of treatment.Recorded before and after treatment for 12,24,72 h of the patient＇s blood lactic acid,myocardial troponin（cT-nI） and b-type natriuretic peptide（BNP） levels and calculate the 12,24,72 h of the patient＇s blood lactate clearance rate.Results Ulinastatin treatment group patients cTnI ,72 h after treatment than the control group was statistically significant difference （ P〈0 .05 ） , the peak of the BNP（24 h） significantly decreased（P〈0.05）.24,72 h increased lactate clearance rate（P〈0.05）,improve tissue perfusion,shorten hospitalization days,the case fatality rate decreased（P〈0.05）.Conclusion Ulinastatin can improve cardiopulmo-nary resuscitation tissue perfusion in patients with myocardial dysfunction ,have certain protection effect ,positive impact on theprognosis of the patients with .