论文部分内容阅读
目的:评价乌司他丁对重危患者肾功能不全的预防及治疗作用,并观察乌司他丁对细胞因子的影响。方法:82例危重病患者随机分为使用组(A组46例)和对照组(B组36例),A组予乌司他丁20万单位每4h一次,B组予等量生理盐水,其他治疗相同。连续5d监测肌酐(Cr)、尿素氮(BUN)、尿NAG,第1,3,5天检测肿瘤坏死因子(TNF)、白介素-1(IL-1)、白介素-6(IL-6)、白介素-10(IL-10),肾功能不全的发生率和血透率,住ICU时间。结果:2组肾功能不全发生率差异无显著性(P>0.05),但A组血透例数少,住EICU时间短于B组。A组TNF、IL-1、IL-6水平在治疗过程中明显低于B组,IL-10高于B组,血BUNB组高于A组(P<0.01)。尿NAG高于A组(P<0.01)。结论:乌司他丁能够减轻各种打击对肾功能的损伤并促进肾功能的恢复,降低血透率,可能与其降低细胞因子TNF、IL-1、IL-6,升高IL-10有关。
Objective: To evaluate the preventive and therapeutic effects of ulinastatin on renal insufficiency in critically ill patients and to observe the effect of ulinastatin on cytokines. Methods: Eighty-two critically ill patients were randomly divided into use group (group A, 46 cases) and control group (group B, 36 cases), group A received ulinastatin 200,000 units every 4 hours, group B received the same amount of normal saline, The same as other treatments. The serum creatinine (Cr), blood urea nitrogen (BUN) and urine NAG were monitored for 5 days. The levels of tumor necrosis factor, interleukin-1, interleukin-6, Interleukin-10 (IL-10), the incidence of renal insufficiency and hemodialysis, live in ICU time. Results: There was no significant difference in the incidence of renal insufficiency between the two groups (P> 0.05). However, the number of hemodialysis cases in group A was less and the duration of EICU was shorter than that in group B. The levels of TNF, IL-1 and IL-6 in group A were significantly lower than those in group B during treatment, while those in group B were higher than those in group B (P <0.01). Urinary NAG was higher than in group A (P <0.01). Conclusion: Ulinastatin can reduce various damage to renal function and promote renal function recovery, reduce the rate of hemodialysis, which may be related to its reduction of cytokines TNF, IL-1, IL-6 and IL-10.