2019 年第 2 期 第 14 卷

乌司他丁对危重症血流感染患者血清炎症因子及血肌酐水平的影响

Effect of ulinastatin on serum inflammatory factors and creatinine in critical patients with bloodstream infection

作者：梁蓓岳岩坤祁佳张玉林

英文作者：

单位：100038北京，首都医科大学附属复兴医院感染科（梁蓓、岳岩坤、祁佳）；100069首都医科大学附属北京佑安医院感染科（张玉林）

英文单位：

关键词：血流感染；危重症；乌司他丁；全身炎症反应综合征；肾功能

英文关键词：

• 摘要：

• 【摘要】目的    探讨乌司他丁对危重症血流感染患者血清炎症因子及血肌酐水平的影响。方法    选取2015年2月至2017年2月首都医科大学附属复兴医院收治的危重症血流感染患者200例，应用随机数字表法分为观察组和对照组，各100例。对照组给予常规治疗，观察组在对照组常规治疗基础上加用乌司他丁治疗，比较2组治疗前和治疗1周后各项生命体征指标(体温、呼吸频率和心率)水平、血清炎症因子［白细胞计数（WBC）、C反应蛋白、降钙素原］水平、血肌酐水平，比较有创通气时间、住重症监护病房（ICU）时间以及28 d病死率的差异。结果    治疗前2组体温、呼吸频率、心率水平比较差异均无统计学意义（均P＞0.05）。治疗1周后2组体温、呼吸频率、心率均低于本组治疗前，且观察组低于对照组，差异均有统计学意义（均P＜0.05）。治疗前2组血清炎症因子及血肌酐水平比较差异均无统计学意义（均P＞0.05）。治疗1周后2组WBC、C反应蛋白、降钙素原及血肌酐水平均低于本组治疗前，且观察组低于对照组［（9.0±2.2）×109/L比（11.4±2.3）×109/L，（20±4）mg/L比（40±4）mg/L，（4.1±1.2）μg/L比（8.7±2.0）μg/L，（39±4）μmol/L比（70±8）μmol/L］，差异均有统计学意义（均P＜0.05）。观察组有创通气时间、住ICU时间和28 d病死率均低于对照组［(7.3±0.5)d比（16.4±1.3）d,(15.1±1.5)d比（27.7±3.2）d，5.0%（5/100）比28.0%(28/100)］，差异均有统计学意义（均P＜0.05）。结论    乌司他丁可有效维持危重症血流感染患者的各项生命体征稳定，同时改善炎性反应，有利于保护患者的肾功能，缩短治疗时间，预后更好。

• 【Abstract】Objective    To investigate the effect of ulinastatin on serum inflammatory factors and creatinine in critical patients with bloodstream infection. Methods    From February 2015 to February 2017, 200 critical patients with bloodstream infection in Fu Xing Hospital, Capital Medical University were randomly divided into observation group and control group, with 100 cases in each group. The control group was given conventional treatment; the observation group was treated with ulinastatin on the basis of conventional treatment. Indexes of vital signs(temperature, respiratory frequency, heart rate), serum inflammatory factors［white blood cell count(WBC), C-reactive protein（CRP）, rocalcitonin］ and serum creatinine were tested before and 1 week after treatment. Invasive ventilation time, intensive care unit(ICU) stay time and the 28 d fatality rate were analyzed. Results    There was no significant difference of temperature, respiratory rate and heart rate between groups before treatment(P>0.05). One week after treatment, temperature, respiratory rate and heart rate in both groups were lower than those before treatment; these indexes in observation group were lower than those in control group(all P<0.05). There was no significant difference of the levels of serum inflammatory factors and creatinine between groups before treatment(P>0.05). One week after treatment, WBC, CRP, calcitonin and serum creatinine levels were lower than those before treatment; the levels in observation group were lower than those in control group［（9.0±2.2）×109/L vs （11.4±2.3）×109/L， （20±4）mg/L vs （40±4）mg/L， （4.1±1.2）μg/L vs （8.7±2.0）μg/L， （39±4）μmol/L vs （70±8）μmol/L］(all P<0.05). Invasive ventilation time, ICU stay time and the 28 d mortality in observation group were shorter/lower than those in control group［(7.3±0.5)d vs （16.4±1.3）d, (15.1±1.5)d vs （27.7±3.2）d， 5.0%（5/100） vs 28.0%(28/100)］(all P<0.05). Conclusion    Ulinastatin can help maintain the stability of vital signs, inhibit inflammatory response, protect renal function, shorten the duration time of therapy in critical patients with bloodstream infection.