摘要
目的研究乌司他丁注射液对感染性休克患者炎症反应、血流动力学、氧合指数(PaO_(2)/FiO_(2))及预后的影响。方法回顾性分析2017年1月至2019年12月感染性休克患者127例临床资料,按照治疗方案分为观察组73例以及常规组54例,两组均按相关指南给予抗休克治疗,观察组另加用乌司他丁治疗,比较两组治疗前后炎症因子、血流动力学参数和PaO_(2)/FiO_(2)变化及恢复情况。结果治疗7 d时两组IL-6、TNF-α以及PCT水平明显降低(P<0.05),且观察组IL-6、TNF-α及PCT水平低于常规组,差异有统计学意义(P<0.05);治疗12 h、24 h和72 h时,两组MAP、CI及PaO_(2)/FiO_(2)明显升高(P<0.05),EVLWI和SVRI明显降低(P<0.05),且同一时间观察组MAP和PaO_(2)/FiO_(2)高于常规组,EVLWI低于常规组,差异有统计学意义(P<0.05);观察组治疗7 d时APACHE-Ⅱ评分、机械通气时间及ICU住院时间均低于常规组,两组MODS发生率分别为4.11%和14.81%(P<0.05),病死率分别为1.37%和7.41%(P>0.05)。结论乌司他丁治疗感染性休克有利于减轻炎症反应,改善血流动力学指标和微循环灌注,对促进患者康复和改善预后具有积极作用。
Objective To evaluate the effect of Ulinastatin injection on inflammation,hemodynamics,oxygenation index(PaO_(2)/FiO_(2))and prognosis in patients with septic shock.Methods A retrospective analysis was performed on clinical data of 109 patients with septic shock from January 2017 to December 2019.Patients were divided into observation group(n=73)and routine group(n=54)according to the treatment regimens.The two groups were given anti-shock treatment according to the relevant guidelines,and observation group was additionally given Ulinastatin.The inflammatory factors,hemodynamic parameters and PaO_(2)/FiO_(2)and recovery were compared between the two groups before and after treatment.Results The levels of IL-6,TNF-αand PCT at 7 d of treatment were significantly decreased in the two groups(P<0.05),and the levels of IL-6,TNF-αand PCT of observation group were lower than that of routine group(P<0.05).At 12 h,24 h and 72 h of treatment,the MAP,CI and PaO_(2)/FiO_(2)were significantly increased in the two groups(P<0.05)while the EVLWI and SVRI were significantly decreased(P<0.05),and the MAP and PaO_(2)/FiO_(2)of observation group at the same time were higher than that of routine group while the EVLWI was lower than that routine group(P<0.05).At 7 d of treatment,the APACHE-II score,mechanical ventilation time and ICU stay time of observation group were lower than that of routine group,and the incidence rates of MODS in the two groups were 4.11%and 14.81%respectively(P<0.05),and the mortality rates were 1.37%and 7.41%respectively(P>0.05).Conclusion Ulinastatin could be beneficial in septic shock,which could reduce inflammatory response,improve hemodynamic parameters and microcirculation perfusion,and put a positive effect on promoting rehabilitation and improving prognosis.
作者
王晓丹
马骁龙
董文星
WANG Xiaodan;MA Xiaolong;DONG Wenxing(Department of Pharmacy,Beidaihe Rehabilitation and Recuperation Center of the PLA,Qinhuangdao 066100,China)
出处
《药学实践与服务》
CAS
2022年第6期576-579,共4页
Journal of Pharmaceutical Practice and Service
