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目的:探讨乌司他丁对老年重症脑出血(ICH)诱导的急性胃肠损伤的影响。方法:选取急性基底节区ICH老年患者60例,按数字表法随机分为治疗组及对照组。对照组给予常规治疗;治疗组在基础治疗上加用乌司他丁60万U,静脉滴注,bid,连用7 d。检测2组治疗前及治疗后第1,3,7天血浆二胺氧化酶(DAO)及D-乳酸水平,并记录2组患者首次肠道排空时间,计算3 d肠道排空率。结果:治疗前,2组D-乳酸及DAO无差异;与对照组比较,治疗组ICH老年患者在3,7 d时D-乳酸及DAO均较对照组显著降低(P<0.01),3 d肠道排空率较对照组显著提高(P<0.05)。结论:乌司他丁可能通过降低肠黏膜的通透性,减轻肠黏膜的损伤,促进老年重症脑出血患者继发的急性胃肠损伤的恢复。
Objective: To investigate the effect of ulinastatin on acute gastrointestinal injury induced by severe intracerebral hemorrhage (ICH) in the elderly. Methods: Sixty elderly patients with ICH in acute basal ganglia were selected and randomly divided into treatment group and control group according to the digital table method. The control group was given routine treatment. The treatment group was given ulinastatin 600,000 U intravenously, bid for 7 days. Plasma diamine oxidase (DAO) and D-lactate levels were measured before and after treatment on the 1st, 3rd, 7th day in the two groups. The time of the first intestinal emptying was recorded and the rate of intestinal emptying was calculated on the 3rd day. Results: Before treatment, there was no difference between two groups of D-lactate and DAO. Compared with the control group, D-lactate and DAO in the treatment group were significantly lower than those in the control group on the 3rd and 7th days (P <0.01) Intestinal emptying rate was significantly higher than the control group (P <0.05). Conclusion: Ulinastatin may reduce the damage of intestinal mucosa by reducing the permeability of intestinal mucosa and promoting the recovery of acute gastrointestinal injury secondary to severe intracerebral hemorrhage.