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目的探讨连续血液净化与乌司他丁联合治疗对重症脓毒血症患者IL-6、TNF-α的影响。方法将2016年1—12月收治的重症脓毒血症患者60例随机分为观察组和对照组各30例,对照组给予抗生素抗感染治疗、给予营养支持、连续性血液净化治疗、做好重症监护等,观察组同时给予乌司他丁辅助治疗,比较两组疗效,组间比较采用t检验,以P<0.05为差异有统计学意义。结果治疗后,观察组APACHEⅡ评分、氧合指数、白细胞分别为(22.1±2.4)分、(348.5±16.6)、(8.9±1.3)×109/L,对照组分别为(28.1±3.4)分、(301.5±17.6)、(12.7±1.6)×109/L。两组比较差异均有统计学意义(t=5.362、6.003、9.862,均P<0.05)。观察组治疗后IL-6、TNF-α水平分别为(23.5±4.6)、(40.3±9.6)ng/L,对照组分别为(44.6±3.9)、(82.6±11.7)ng/L,两组比较差异均有统计学意义(t=12.052、16.786,均P<0.05)。结论连续血液净化与乌司他丁联合治疗能够有效抑制重症脓毒血症炎症反应,疗效显著。
Objective To investigate the effects of continuous blood purification combined with ulinastatin on IL-6 and TNF-α in patients with severe sepsis. Methods Sixty patients with severe sepsis admitted from January to December in 2016 were randomly divided into observation group (30 cases) and control group (30 cases). The control group was given anti-infective antibiotics treatment. Nutritional support, continuous blood purification treatment Intensive care, the observation group also given ulinastatin adjuvant therapy, the efficacy of the two groups were compared between the two groups using t test to P <0.05 for the difference was statistically significant. Results After treatment, APACHEⅡscore, oxygenation index and leucocyte in the observation group were (22.1 ± 2.4) points, (348.5 ± 16.6) and (8.9 ± 1.3) × 109 / L respectively, while those in the control group were (28.1 ± 3.4) (301.5 ± 17.6) and (12.7 ± 1.6) × 109 / L, respectively. The differences between the two groups were statistically significant (t = 5.362,6.003,9.862, both P <0.05). The levels of IL-6 and TNF-α in the observation group were (23.5 ± 4.6) and (40.3 ± 9.6) ng / L, respectively, and those in the control group were (44.6 ± 3.9) and (82.6 ± 11.7) ng / The differences were statistically significant (t = 12.052,16.786, all P <0.05). Conclusion The combination of continuous blood purification and ulinastatin can effectively inhibit the inflammatory reaction of severe sepsis with significant curative effect.