| 乌司他丁对感染性休克患者炎症反应、血流动力学、PaO2/FiO2及预后的影响 |
| 投稿时间：2022-06-20 修订日期：2022-09-14 点此下载全文 |
| 引用本文：王晓丹,马骁龙,董文星.乌司他丁对感染性休克患者炎症反应、血流动力学、PaO2/FiO2及预后的影响[J].药学实践杂志,2022,40(6):576~579 |
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| 中文摘要: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（PaO2/FiO2）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PaO2/FiO2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PaO2/FiO2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PaO2/FiO2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。 |
| 中文关键词:感染性休克 乌司他丁注射液 血流动力学 病死率 |
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| Effects of Ulinastatin on inflammatory response, hemodynamics, PaO2/FiO2 and prognosis in patients with septic shock |
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| Abstract:Objective To evaluate the effect of Ulinastatin injection on inflammation, hemodynamics, oxygenation index (PaO2/FiO2) 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 PaO2/FiO2 and recovery were compared between the two groups before and after treatment. Results The levels of IL-6, TNF-α and PCT at 7 d of treatment were significantly decreased in the two groups (P<0.05), and the levels of IL-6, TNF-α and 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 PaO2/FiO2 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 PaO2/FiO2 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. |
| keywords:septic shock Ulinastatin injection hemodynamics mortality rates |
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