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【目的】探讨乌司他丁对阿维菌素中毒性休克并心肌损伤患者早期组织灌注、全身氧代谢的影响及对心肌损伤的保护作用【方法】本院30例阿维菌素中毒性休克并心肌损伤患者，随机分为对照组与观察组，均予以洗胃、补液、血液净化等常规处理，而观察组在此基础上加用乌司他丁静脉滴注。比较对照组与观察组用药24 h前后组织灌注、全身氧代谢指标的变化及最终血压恢复平稳时间的差异；比较两组治疗前及治疗后1d、3d、5d血液内心肌损伤标志物（LDH、AST 、CK、CK‐MB、cTnI）含量的变化；比较两组 ICU 平均住院时间和28 d预后的差异。【结果】观察组用药24 h后血乳酸值低于对照组，24 h乳酸清除率、尿量、ScvO2高于对照组，血压恢复平稳时间短于对照组，且两组相比较差异有显著性（P ＜0．05）；两组治疗前及治疗后1d血液内心肌损伤标志物含量相近（P＞0．05），但治疗后3d、5d观察组心肌损伤标志物含量少于对照组（P ＜0．05）；观察组ICU平均住院时间明显短于对照组（P ＜0．05），但两组28d病死率相比较差异无显著性（P ＞0．05）。【结论】乌司他丁可改善阿维菌素中毒性休克并心肌损伤患者早期组织灌注水平及全身氧代谢状况，对心肌损伤具有保护作用，可缩短IC U平均住院时间，但对28 d病死率无影响。“,”[Objective] To explore the protective effects of ulinastatin on early tissue perfusion and systemic ox‐ygen metabolism in patients with avermectin toxic shock and myocardial injury .[Methods] A total of 30 patients with avermectin toxic shock and myocardial injury were randomly divided into control and treatment groups .Both groups received routine measures of gastric lavage ,fluid replacement and blood purification while treatment group used ulinastatin additionally .The differences in the parameters of tissue perfusion and systemic oxygen metabolism were observed .Also the time of blood pressure recovery after 24h treatment ,the changes in content of blood mark‐ers of myocardial injury (lactate dehydrogenase ,aspartate transaminase ,creatine kinase ,creatine kinase‐MB & tro‐ponin I) at pre‐treatment and after 1/3/5‐day treatment ,average stay in ICU and prognosis after 28 days were com‐pared .[Results] The amount of blood lactic acid was lower in treatment group than that in control group .And 24h lactate clearance ,urine output and ScvO2 in treatment group were higher than those in control group .The time of blood pressure recovery was shorter in treatment group than that in control group .And the differences were signifi‐cant ( P0 .05) .However ,the contents of blood markers of myocardial injury were lower af‐ter 3/5‐day treatment in treatment group ( P <0 .05) .The average stay in ICU was significantly shorter in treat‐ment group than that in control group ( P 0 .05) .[Conclusion] Ulinastatin can improve early tissue perfusion and systemic oxygen metabolism and protect my‐ocardial muscles in patients with avermectin toxic shock and myocardial injury .The average stay in ICU may be shortened .However ,it has no effect on mortality after 28 days .