临床误诊误治2018，Vol.31Issue(2)：56-62,7.DOI:10.3969/j.issn.1002-3429.2018.02.016
乌司他丁联合持续性肾脏替代疗法治疗感染性休克临床效果观察
Clinical Efficacy of Ulinastatin Combined with Continuous Renal Replacement in Treatment of Patients with Septic Shock
摘要
Abstract
Objective To observe clinical effect of Ulinastatin combined with continuous renal replacement in treat-ment of patients with septic shock. Methods A total of 901 patients with septic shock,who had met the inclusion and exclu-sion criteria,were divided into group A, B and C (n=30 for each group) using computer random number table method. Group A was given routine therapy,and group B was added with continuous renal replacement therapy(CRRT),while group C was added with Ulinastatin combined with CRRT on the basis of routine therapy. Blood leukocytes,procalcitonin(PCT),c-reactive protein (CRP),interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor alpha (TNF-α), blood lactic acid (Lac),oxygenation index (PaO2/FiO2), serum creatinine (SCr), blood urea (BUN) level and acute physiology and chronic health evaluation system II(APACHE II) scores before and at 3 and 7 days after treatment,and fatality rates at 3 and 7 days after treatment were observed and compared in three groups. Results In three groups,at 3 and 7 days after treatment, blood leukocytes,PCT,CRP,IL-6,IL-10,TNF-α,Lac,SCr and BUN levels,and APACHE II scores were significantly de-creased,while PaO2/FiO2values were significantly higher than those before treatment, and with increasing treatment time, decreased blood leukocytes,PCT,CRP,IL-6,IL-10,TNF-α,Lac,SCr and BUN levels and APACHE II scores were more obvious,while increased PaO2/FiO2values were also more obvious, and the differences were statistically significant (P <0.05). At 3 and 7 days after treatment,there were significant differences in leukocytes, PCT, CRP, IL-6, IL-10, TNF-α,Lac,PaO2/FiO2,SCr and BUN levels and APACHE II scores among three groups (P<0.05). In group B and C, leuko-cytes,PCT,CRP,IL-6,IL-10,TNF-α,Lac,SCr and BUN levels, and APACHE II scores were significantly lower, while PaO2/FiO2values were significantly higher than those in group A;in group C,leukocytes,PCT,CRP,IL-6,IL-10,TNF-α, Lac,SCr and BUN levels,and APACHE II scores were significantly lower,while PaO2/FiO2values were significantly higher than those in group B(P<0.05). At 3 and 7 days after treatment,there were significantly differences in mortality rate among three groups (P<0.05),and the fatality rates in group B and C were significantly lower than that in group A (P<0.05). Conclusion Ulinastatin combined CRRT in treatment of patients with septic shock may inhibit inflammatory reaction, in-crease blood flow of tissue reperfusion by removing inflammatory factors,improve hemodynamics and maintain a stable internal environment so as to reduce fatality rate.关键词
乌司他丁/肾替代疗法/休克,脓毒性Key words
Ulinastatin/Renal replacement therapy/Shock,septic分类
医药卫生引用本文复制引用
虎琼华,周瑜,张鸣,崔巍,徐治波,高柯,徐兵..乌司他丁联合持续性肾脏替代疗法治疗感染性休克临床效果观察[J].临床误诊误治,2018,31(2):56-62,7.基金项目
四川省卫生厅科研课题(130413) （130413）
