| 何浩胡亮何彩霞崔嵘夏凤强李成.乌司他丁联合连续性血液净化治疗重症脓毒症临床研究[J].,2011,11(17):3334-3338 |
| 乌司他丁联合连续性血液净化治疗重症脓毒症临床研究 |
| Clinical study on treatment of continuous blood purification combinedwith Ulinastatin for patients with severe sepsis |
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| DOI： |
| 中文关键词: 脓毒症 连续性血液净化 乌司他丁 炎症反应 |
| 英文关键词: Sepsis Continuous blood purification Ulinastatin Inflammatory response |
| 基金项目: |
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| 中文摘要: |
| 目的：研究连续性血液净化联合乌司他丁对重症脓毒症患者炎症反应的影响及其临床疗效。方法：70 例重症脓毒症患者随
机分为对照组（n=22 例）、CBP 组（n=23 例）和CBP+ 乌司他丁组（n=25 例），其中对照组采用经典治疗方案，CBP 组在此基础上加
用连续性血液净化，CBP+ 乌司他丁组在CBP 组基础上加用乌司他丁治疗。观察比较患者病情发展，分别于治疗前后进行血液生
化指标、凝血功能检测和动脉血气分析，ELISA 法检测血清CRP 水平。结果：①与对照组和CBP 组相比，CBP+ 乌司他丁组患者病
死率、ICU 住院时间、MODS 发生率均明显下降(P<0.05)。②经过治疗，CBP+ 乌司他丁组患者APACHE II 评分降至15.46±3.96，
与对照组（18.06±4.25）和CBP 组（17.14±5.55）比较差异有统计学意义（P<0.05）。③治疗后，患者BUN、HR 降低程度依次为
CBP+ 乌司他丁组>CBP 组> 对照组，组间比较差异有显著性(P<0.05)，而治疗前后PH 值、HCO3-、MAP 比较差异不明显(P>0.
05)。④CBP+ 乌司他丁组血清CRP 含量下降，WBC 数量减少，其变化程度明显大于CBP 组和对照组(P<0.05)。⑤对照组、CBP 组
和CBP+ 乌司他丁组患者PT、TT 和APTT 时间延长，血小板数量下降，其中CBP+ 乌司他丁组PT、APTT 时间短于CBP 组和对
照组(P<0.05)。结论：连续性血液净化联合乌司他丁可有效抑制脓毒症患者炎症反应，缓解病情，改善患者预后。 |
| 英文摘要: |
| Objective: To investigate the effect of continuous blood purification combined Ulinastatin on inflammation of patients
with severe sepsis, as well as the clinical outcomes. Methods: 70 cases with severe sepsis subsequently divided into control group (n=22),
CBP group (n=23) and CBP+ Ulinastatin group (n=25). The control group received classical treatment. the CBP group was added with
continuous blood purification, and the CBP+ Ulinastatin group with Ulinastatin. The development of disease was observed, and the blood
biochemical parameters, coagulation index and arterial blood gas analyses were evaluated before and after treatment. ELISA was used to
quantify the serum concentration of CRP. Results:①Compared with control and CBP group, the case-fatality rate, length of ICU stay and
rate of MODS significantly decreased in CBP+ Ulinastatin group (P<0.05). ②After treatment, the APACHE II score CBP+Ulinastatin
group fell to 15.46±3.96, significantly lower than control group (18.06±4.25) and CBP group (17.14±5.55) (P<0.05). ③ The levels of
BUN and HR was lowest in CBP+ Ulinastatin group, followed successively by CBP and control group. (P<0.05) But no difference was
found in PH, HCO3- and MAP among groups (P>0.05). ④ After treatment, the levels of serum CRP and WBC significantly decreased,
especially in CBP+Ulinastatin group (P<0.05). ⑤PT, TT and APTT increased in all patients, and PLT decreased. The PT and APTT was
shorter in CBP+Ulinastatin group than control and CBP group (P<0.05). Conclusion: Combination of continuous blood purification and
Ulinastatin for the treatment of severe sepsis can inhibit inflammatory response, reduce the severity of the sepsis, and improve prognosis. |
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