摘要
目的探讨乌司他丁对严重脓毒症和感染性休克患者氧化应激水平的影响及其临床意义。方法选择急诊科EICU收治的86例严重脓毒症以及感染性休克患者，随机分为治疗组（n=46）和对照组（n=40）。两组患者均按照2012年国际严重脓毒症和感染性休克治疗指南推荐意见进行治疗。治疗组在此基础上静脉注射乌司他丁，对照组给以等量的生理盐水，分别在用药前和5d后测定血清总超氧化物岐化酶（T—SOD）活力、总抗氧化力（T—AOC）和丙二醛（MDA）含量，比较两组间差别；同时比较两组患者28d病死率。结果用药前两组患者T—SOD活力、T—AOC和MDA差异无统计学意义（P〉0．01）；5d后治疗组T—SOD活力和T—AOC显著高于对照组、MDA含量显著低于对照组（P〈0．01）；治疗组患者28d病死率低于对照组，差异无统计学意义（P〉0．01）。结论应用乌司他丁可能会减轻严重脓毒症和感染性休克患者体内氧化应激水平，但未能改善28d病死率。
Objective To explore the effects of ulinastatin on oxidative stress in patients with severe sepsis and septic shock. Methods A total of 86 patients suffering with severe sepsis and septic shock in EICU were enrolled into the current study. They were randomly divided into a treatment group （n=46） and a control group （n=40）. Both groups were treated according to 2012 International Guidelines for Management of Severe Sepsis and Septic Shock. Moreover, patients in the treatment group were additionally intravenously injected with ulinastatin, while the same volume of normal saline was given in the control group. Then, the two groups were compared for serum malondialdehyde （MDA） content, total superoxide dismutase （T-SOD） activity and total anti-oxidation capacity （T-AOC） before treatment and 5 days later. Meanwhile, 28-day mortality was recorded in both groups. Results Both groups presented no significant difference in T-SOD activity, and T-AOC and MDA contents before treatment （P〉 0.01）. But 5 days later, patients in the treatment groups produced remarkably enhanced T-SOD activity and a higher amount of T-AOC but a reduced content of MDA in comparison with the control （P 〈 0.01）. A low 28 day-mortality was seen in the treatment group than in the control, in spite of no statistical difference （P〉 0.01）. Conclusion The use of ulinastatinmaybe can protect patients with severe sepsis and septic shock against oxidative stress. However it may not be helpful for 28-day morality.
出处
《中国急救复苏与灾害医学杂志》
2016年第4期383-385,共3页
China Journal of Emergency Resuscitation and Disaster Medicine
