2018 年第 3 期 第 13 卷

乌司他丁对严重腹腔感染患者临床疗效及炎性介质和免疫系统的影响

Clinical effect of ulinastatin on inflammatory mediators and immune system in patients with severe abdominal infection

作者：冯雪亮尹兆强苑昭奖魏军利高文生

英文作者：

单位：056001河北省邯郸钢铁集团有限责任公司职工医院普外科（冯雪亮、尹兆强）；056000河北省邯郸市中心医院普外科（苑昭奖）；056000河北省邯郸市磁县人民医院普外科（魏军利、高文生）

英文单位：

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• 摘要：

• 目的    探讨乌司他丁治疗严重腹腔感染的临床效果及对患者炎性介质和免疫系统的影响。方法    选择2013年10月至2017年10月在河北省邯郸钢铁集团有限责任公司职工医院普外科接受治疗的严重腹腔感染患者140例。采用随机数字表法分为对照组和观察组，各70例。对照组采用头孢曲松钠、甲硝唑注射液静脉滴注治疗，观察组在对照组基础上加用乌司他丁静脉滴注治疗。比较2组临床疗效及血清降钙素原、C反应蛋白（CRP）、白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）、血乳酸和免疫球蛋白（Ig）A、IgG、IgM水平。结果    治疗1个月后，观察组有效率高于对照组［94.3%（66/70）比85.7%（60/70）］，降钙素原、CRP、IL-6、TNF-α、血乳酸水平低于对照组［（0.41±0.27）μg/L比（0.82±0.29）μg/L、（8.4±0.4）mg/L比（13.2±1.0）mg/L、（14.0±2.0）μg/L比（20.1±2.0）μg/L、（10.4±1.1）μg/L比（14.0±1.3）μg/L、（2.1±0.3）mmol/L比（2.9±0.4）mmol/L］，IgA、IgG、IgM水平高于对照组［（2.3±0.7）g/L比（2.0±0.5）g/L、（11.2±2.0）g/L比（8.8±1.9）g/L、（1.1±0.6）g/L比（1.0±0.5）g/L］，差异均有统计学意义（均P<0.05）。2组治疗期间药物不良反应发生率比较差异无统计学意义（P>0.05）。结论    将乌司他丁用于严重腹腔感染患者中有助于提高临床疗效，降低炎症因子水平，提高机体免疫系统调节作用。

• Objective    To investigate the clinical effect of ulinastatin on inflammatory mediators and immune system in patients with severe abdominal infection. Methods    Totally 140 patients with severe abdominal infection were enrolled from October 2013 to October 2017 in Hebei Handan Iron and Steel Refco Group Ltd Staff Hospital; they were randomly divided into control group and observation group, with 70 cases in each group. The control group had intravenous drip infusion of ceftriaxone sodium and metronidazole; the observation group had intravenous drip infusion of ulinastatin on the basis of control group. Clinical efficacy, serum levels of procalcitonin(PCT), C-reactive protein(CRP), interleukins-6（IL-6）, tumor necrosis factor-α(TNF-α), blood lactic acid and immunoglobulin(Ig)A, IgG, IgM were analyzed. Results    One month after treatment, the effective rate in observation group was significantly higher than that in control group［94.3%（66/70） vs 85.7%（60/70）］; levels of PCT, CRP, IL-6, TNF-α and blood lactic acid in observation group were significantly lower than those in control group［（0.41±0.27）μg/L vs （0.82±0.29）μg/L, （8.4±0.4）mg/L vs （13.2±1.0）mg/L, （14.0±2.0）μg/L vs （20.1±2.0）μg/L,（10.4±1.1）μg/L vs （14.0±1.3）μg/L, （2.1±0.3）mmol/L vs （2.9±0.4）mmol/L］; levels of IgA, IgG and IgM in observation group were significantly higher than those in control group［（2.3±0.7）g/L vs （2.0±0.5）g/L,（11.2±2.0）g/L vs （8.8±1.9）g/L, （1.1±0.6）g/L vs （1.0±0.5）g/L］（all P<0.05）. The adverse event rate showed no significant difference between groups(P＞0.05). Conclusion    Ulinastatin treating patients with severe abdominal infection can effectively increase clinical curative effect, reduce inflammatory factors and improve immune regulation.