Abstract
Objective To observe the clinical effect of ulinastatin(UTI)combined with thymosin alpha 1(Tα1)in the treatment of septic shock.Methods A retrospective analysis was conducted on the clinical data of 88 patients with septic shock admitted to our hospital from June 2021 to October 2023.The patients were divided into UTI group and UTI+Tα1 group according to different treatment methods,with 44 patients in each group.The treatment effects,clinical indicators,microcirculatory perfusion indicators[central venous oxygen saturation(ScvO2),lactate(LAC),capillary refill time(CRT),mean arterial pressure(MAP)],Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,Sequential Organ Failure Assessment(SOFA)score,immune indicators,plas-ma and serum inflammatory indicators[soluble triggering receptor expressed on myeloid cells-1(sTREM-1),procalcitonin(PCT),interleukin(IL)-6,tumor necrosis factor-α(TNF-α)],and prognosis were compared between the two groups.Results After 7 days of treatment,the effective rate of treatment in the UTI+Tα1 group was higher than that in the UTI group(P＜0.05).The dura-tion of vasoactive drug use,mechanical ventilation time,ICU stay,and hospital stay were shorter in the UTI+Tα1 group than those in the UTI group(P＜0.05).After 24 and 72 hours of treatment,ScvO2 and MAP gradually increased,LAC gradually decreased,and CRT gradually shortened in both groups(P＜0.05).After 24 hours of treatment,ScvO2 and MAP were higher,and CRT was shorter in the UTI+Tα1 group than those in the UTI group(P＜0.05).After 72 hours of treatment,CRT was shorter,and MAP was higher in the UTI+Tα1 group than those in the UTI group(P＜0.05).After 7 days of treatment,both APACHE Ⅱ and SOFA scores decreased in both groups compared to treatment before,and their scores were lower in the UTI+Tα1 group than those in the UTI group(P＜0.05).After 7 days of treatment,the levels of CD3+and CD4+T lymphocytes increased in both groups compared to treatment before,and the levels were higher in the UTI+Tα1 group than those in the UTI group(P＜0.05).After 7 days of treatment,the levels of sTREM-1,PCT,IL-6,and TNF-α decreased in both groups compared to treatment before,and the levels were lower in the UTI+Tα1 group than those in the UTI group(P＜0.05).After a 28-day follow-up,there was no sta-tistically significant difference in mortality between the two groups(P=0.398).Conclusion UTI combined with Tα1 can effectively promote the recovery of patients with septic shock,improve micro-circulatory perfusion,reduce plasma sTREM-1 and serum PCT levels,inhibit inflammatory responses,and improve prognosis.关键词
脓毒性休克/乌司他丁/胸腺肽α1/可溶性髓样细胞触发受体-1/急性生理与慢性健康状况评估系统Ⅱ/序贯器官衰竭评估Key words
septic shock/ulinastatin/thymosin alpha 1/soluble triggering receptor ex-pressed on myeloid cells-1/Acute Physiology and Chronic Health Evaluation Ⅱ/Sequential Organ Failure Assessment分类
医药卫生
