| 刘金岩,王 斌,张永萍,张 燕,王 燕.不同剂量乌司他丁联合阿拓莫兰对感染性休克患者氧化应激、炎症反应及预后的影响[J].,2019,19(17):3321-3325 |
| 不同剂量乌司他丁联合阿拓莫兰对感染性休克患者氧化应激、炎症反应及预后的影响 |
| Effects of Different Doses of Ulinastatin Combined with Atomolan on Oxidative Stress, Inflammation Reaction and Prognosis in Patients with Septic Shock |
| 投稿时间：2019-03-21 修订日期：2019-04-17 |
| DOI：10.13241/j.cnki.pmb.2019.17.025 |
| 中文关键词: 乌司他丁 阿拓莫兰 剂量 感染性休克 氧化应激 炎症反应 预后 |
| 英文关键词: Ulinastatin Atomolan Dose Septic shock Oxidative stress Inflammatory reaction Prognosis |
| 基金项目:新疆维吾尔自治区自然科学基金面上项目（201233146-18） |
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| 中文摘要: |
| 摘要 目的：探讨不同剂量乌司他丁联合阿拓莫兰对感染性休克患者血清氧化应激、炎症反应以及预后的影响。方法：选择2014年5月至2018年6月我院诊治的100例感染性休克患者，按随机数字表法分为乌司他丁组（乌司他丁20万U/d）、阿拓莫兰组（阿拓莫兰1.8 g/d）、低剂量联合组（乌司他丁20万U/d+阿拓莫兰1.8 g/d）、高剂量联合组（乌司他丁40万U/d+阿拓莫兰1.8 g/d），每组各25例。对比四组患者治疗前后的血清氧化应激指标[丙二醛(MDA)、晚期氧化蛋白产物(AOPP)，超氧化物歧化酶(SOD)、总抗氧化能力(T-AOC )、谷胱甘肽过氧化物酶(GSH-Px)]、炎症反应指标[白介素-6(IL-6)、肿瘤坏死因子-α（TNF-α)、降钙素原(PCT)、C反应蛋白（CRP）]的变化，并对比四组患者预后的差异。结果：高剂量联合组患者ICU住院时间、机械通气时间、治疗后急性生理与慢性健康量表(APACHEⅡ)评分、序贯器官衰竭（SOFA）评分、血清MDA、AOPP、IL-6、TNF-α、PCT、CRP水平均低于乌司他丁组、阿拓莫兰组、低剂量联合组，低剂量联合组低于乌司他丁组、阿拓莫兰组（P＜0.05）。高剂量联合组治疗后血清SOD、T-AOC、GSH-Px高于乌司他丁组、阿拓莫兰组、低剂量联合组，低剂量联合组高于乌司他丁组、阿拓莫兰组（P＜0.05）。高剂量联合组、低剂量联合组患者多器官功能障碍（MODS）发生率和死亡发生率均低于乌司他丁组、阿拓莫兰组（P＜0.05）。结论：乌司他丁联合阿拓莫兰治疗感染性休克效果显著，可有效抑制全身氧化应激和炎性反应，改善患者预后，且高剂量乌司他丁联合阿拓莫兰治疗感染性休克的效果最优。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the effect of different doses of ulinastatin combined with atomolan on serum oxidative stress, inflammatory reaction and prognosis in patients with septic shock. Methods: 100 patients with septic shock who were treated in our hospital from May 2014 to June 2018 were selected. According to the random number table method, the patients were divided into the ulinastatin group (ulinastatin 200,000 U/d), the atomolam group (atomolam 1.8 g/d), the low-dose combination group (ulinastatin 200,000 U/d and atomolam 1.8 g/d), the high-dose combination group (ulinastatin 400,000 U/d and atomolam 1.8 g/d), with 25 cases in each group. The changes of oxidative stress indexes [malondialdehyde (MDA), advanced oxidation protein products (AOPP), superoxide dismutase (SOD) and total antioxidant capacity (T-AOC), glutathione peroxidase (GSH-Px)] and inflammation indexes[interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), procalcitonin (PCT) and c-reactive protein (CRP)] of patients between the three groups before and after treatment were compared. Meanwhile, the differences in prognosis between the three groups were compared. Results: The ICU hospitalization time, mechanical ventilation time, acute physiological and chronic health (APACHE II) scores and sequential organ failure (SOFA) scores, and the level of serum MDA, AOPP, IL-6, TNF-α, PCT and CRP after treatment of patients in the high-dose combined group were all lower than those in the ulinastatin group, the atomolam group, and the low-dose combined group, while the low-dose combined group were lower than those in the ulinastatin group and the atomolam group (P＜0.05). The level of serum SOD, T-AOC, GSH-Px after treatment of patients in the high-dose combined group were all higher than those in the ulinastatin group, the atomolam group, and the low-dose combined group, while the low-dose combined group were higher than those in the ulinastatin group and the atomolam group (P＜0.05). The incidence of multiple organ dysfunction (MODS) and mortality in patients of the high-dose combined group and the low-dose combined group were lower than those in the ulinastatin group and the atomolam group (P＜0.05). Conclusion: Ulinastatin combined with atomolan is effective in the treatment of dyeability shock. It can effectively inhibit systemic oxidative stress and inflammatory reaction and improve the prognosis of patients, high dose ulinastatin combined with the treatment of septic shock is the best. |
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