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目的观察心肺复苏术(CPR)后全身炎症反应综合征(systemic inflammatory response syndrome,SIRS)的发生,探讨乌司他汀对炎症介质的干预作用。方法将2005年12月至2007年8月中南大学湘雅医院急诊科救治的CPR后存活>72h的32例患者,随机分为乌司他汀治疗组(n=15)和对照组(n=17),以10名体检健康者为正常组(n=10),治疗组和对照组于心脏搏动恢复72h后抽取外周血,比较3组肿瘤坏死因子-α(tumor necrosisfactor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6),同时对患者进行SIRS的评估。结果CPR后两组患者外周血TNF-α、IL-6均高于正常组(P<0.01)。治疗组患者TNF-α、IL-6明显低于对照组(P<0.01)。治疗组患者SIRS的发生率明显低于对照组(20.0%对64.7%)。结论乌司他汀能够有效地抑制CPR后机体炎症反应,可能对患者重要脏器功能起到保护作用。
Objective To observe the occurrence of systemic inflammatory response syndrome (SIRS) after cardiopulmonary resuscitation (CPR) and to investigate the intervention effect of ulinastatin on inflammatory mediators. Methods Thirty-two patients who survived more than 72 hours after CPR were treated in emergency department of Xiangya Hospital of Central South University from December 2005 to August 2007 were randomly divided into ulinastatin group (n = 15) and control group (n = 17) ), 10 healthy subjects were selected as the normal group (n = 10). Peripheral blood was collected 72 h after heart beat recovery in the treatment group and the control group. Tumor necrosis factor-α (TNF-α) , Interleukin-6 (IL-6) in patients with SIRS. Results The levels of TNF-α and IL-6 in the peripheral blood of the two groups after CPR were higher than those of the normal group (P <0.01). The levels of TNF-α and IL-6 in the treatment group were significantly lower than those in the control group (P <0.01). The incidence of SIRS in the treatment group was significantly lower than that in the control group (20.0% vs. 64.7%). Conclusion Ulinastatin can effectively inhibit the inflammatory response after CPR and may play a protective role in the vital organs of patients.