乌司他丁联合持续性肾脏替代治疗对尿源性脓毒血症患者炎性因子、氧化应激水平及免疫指标的影响

目的 分析乌司他丁联合持续性肾脏替代治疗对尿源性脓毒血症患者炎性因子、氧化应激水平及免疫指标的影响。方法 选择2018年4月至2020年4月期间就诊于本院的60例尿源性脓毒血症患者作为研究对象，按入院次序将其分成两组，对照组采用常规治疗+持续性肾脏替代治疗（29例），研究组采用常规治疗+持续性肾脏替代治疗+乌司他丁（31例）。比较两组的血肌酐、血尿素、炎性因子、氧化应激、免疫指标等情况。结果 两组治疗后的CD3⁺、CD4⁺、CD4⁺/CD8⁺均高于治疗前（均P<0.001），CD8⁺低于治疗前（P<0.001），且研究组治疗后的CD3⁺、CD4⁺、CD4⁺/CD8⁺均高于对照组（均P<0.05），CD8⁺低于对照组（P<0.05）；治疗后两组的血肌酐与血尿素水平均低于治疗前（均P<0.05），且研究组治疗后的血肌酐与血尿素水平均低于对照组（均P<0.05）；两组治疗后的肿瘤坏死因子 α（TNF-α）、白细胞介素-10（IL-10）与白细胞介素-1β（IL-1β）水平均低于治疗前（均P<0.05），且治疗后研究组的TNF-α、IL-10与IL-1β水平均低于对照组（均P<0.05）；两组治疗后的丙二醛（MDA）低于治疗前（P<0.05），超氧化物歧化酶（SOD）、过氧化氢酶（CAT）均高于治疗前（均P<0.05），且治疗后研究组的MDA低于对照组（P<0.05），SOD、CAT均高于对照组（均P<0.05）。结论 乌司他丁联合持续性肾脏替代治疗尿源性脓毒血症能减轻机体炎症反应与氧化应激水平，提高肾功能与免疫功能。

The effects of urinastatin combined with continuous renal replacement therapy on inflammatory factors,oxidative stress level and immune indexes in patients with urogenous sepsis

Objective  To analyze the effects of urinastatin combined with continuous renal replacement therapy on inflammatory factors, oxidative stress level and immune indexes in patients with urogenous sepsis.Methods  From April 2018 to April 2020, 60 patients with urogenous sepsis in our hospital were selected as the subjects, and they were divided into two groups according to the order of admission, among them, 29 patients in the control  group were treated with routine treatment+continuous renal replacement treatment, and 31 patients in the study group were treated with routine treatment+continuous renal replacement treatment+urinastatin. The changes of serum creatinine，urea, inflammatory factors, oxidative stress and immune indexes were compared between the two groups.Results  After treatment, CD3⁺, CD4⁺, CD4⁺/CD8⁺ of the two groups were higher than those before treatment (all P<0.05), and CD8⁺ was lower than that before treatment (P<0.05), meanwhile, after treatment, CD3⁺, CD4⁺, CD4⁺/CD8⁺ in the study group were higher than those in the control group (all P<0.001), and CD8⁺ was lower than that in the control group (P<0.001). The results of serum creatinine and blood urea in the two groups after treatment were lower than those before treatment (all P<0.05), and the results of serum creatinine and blood urea in the study group after treatment were lower than those in the control group (all P<0.05). After treatment, the levels of tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10) and interleukin-1β (IL-1β) were lower than those before treatment (all P<0.05), and after treatment, the levels of TNF-α, IL-10 and IL-1β in the study group were lower than those in the control group (all P<0.05). After treatment, the malondialdehyde (MDA) was lower than that before treatment, and superoxide dismutase (SOD) and catalase (CAT) were lower than those before treatment (all P<0.05), meanwhile, after treatment, MDA in the study group was lower than that in the control group (P<0.05), and SOD and CAT were higher than those in the control group (all P<0.05). Conclusions  Urinastatin combined with continuous renal replacement therapy for urogenous sepsis can reduce the levels of inflammation and oxidative stress, and improve the renal function and immune function.