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目的探讨乌司他丁对重度脓毒症患者心功能的影响。方法将40例重度脓毒症患者,随机分为对照组和治疗组,每组20例,对照组给予脓毒症一般治疗,治疗组在对照组基础上加用乌司他丁,30万单位,静推,每8 h一次,连用5 d。治疗组和对照组分别在入ICU后和治疗后第5天抽静脉血,测心肌钙蛋白(cTnI)、B-型钠尿肽前体(NT-proB-NP)、白介素-6(IL-6)等指标变化,抽动脉血测乳酸(Lac)的变化,同时记录两组患者心指数(CI)、急性生理和慢性健康状况评分(APACHEⅡ评分)的变化。结果治疗组治疗第5天后各项检测指标与对照组比较差异有统计学意义(P<0.05),两组APACHEⅡ评分均较治疗前下降,且治疗5 d后治疗组较对照组下降明显。结论乌司他丁对重度脓毒症患者心功能具有保护作用,从而能够改善重度脓毒症患者的预后。
Objective To investigate the effect of ulinastatin on cardiac function in patients with severe sepsis. Methods Forty patients with severe sepsis were randomly divided into control group and treatment group, 20 cases in each group. The control group was given general treatment of sepsis. The treatment group was treated with ulinastatin and 300000 units , Static push, once every 8 h, once every 5 d. After treatment with ICU and control group, venous blood was taken from the fifth day after treatment and cTnI, NT-proB-NP, IL- 6) were measured. Changes of lactic acid (Lac) were measured by tachycardia. Changes of cardiac index (CI), acute physiology and chronic health status score (APACHEⅡ) in both groups were also recorded. Results After treatment for 5 days, the detection indexes in the treatment group were significantly different from those in the control group (P <0.05). The APACHEⅡ scores of the two groups decreased compared with those before treatment, and decreased significantly in the treatment group after 5 days of treatment. Conclusion Ulinastatin has a protective effect on heart function in patients with severe sepsis, which can improve the prognosis of patients with severe sepsis.