连续性肾脏替代疗法联合乌司他丁治疗严重脓毒症的临床疗效
Efficacy of ulinastatin supplementation with continuous renal replacement therapy in the treatment of severe sepsis
方丽丽 1付丽影 1张星城2
作者信息
- 1. 236000 安徽省阜阳市,阜阳职业技术学院
- 2. 阜阳市第二人民医院重症医学科外科病区
- 折叠
摘要
目的 探究连续性肾脏替代疗法(CRRT)联合乌司他丁治疗严重脓毒症(SS)的临床疗效.方法 选择2020 年 4 月至 2023 年 12 月医院收治的 72 例SS患者作为研究对象,在组间基线资料均衡可比原则的基础上,采用随机数字表法分为对照组和观察组,各 36 例.对照组给予CRRT,观察组在对照组基础上给予乌司他丁治疗,两组均持续治疗1周.对比两组患者治疗前后炎性因子[降钙素原(PCT)、C反应蛋白(CRP)和白细胞介素-6(IL-6)]、凝血功能[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)和血小板计数(PLT)]及急性生理与慢性健康Ⅱ(APACHEⅡ)量表评分、序贯器官衰竭(SOFA)评分,并统计两组患者弥漫性血管内凝血(DIC)、多器官功能衰竭(MODS)发生率及病死率.结果 治疗 7d后,观察组患者的PCT、CRP和IL-6 等炎性因子水平显著低于对照组,差异均有统计学意义(P<0.05).治疗7d后,观察组患者的APTT、PT、TT等凝血功能指标水平低于对照组,而PLT水平高于对照组,差异均有统计学意义(P<0.05).治疗 7d后,观察组患者的APACHEⅡ评分、SOFA评分低于对照组,差异有统计学意义(P<0.05).观察组患者的DIC发生率、MODS发生率、病死率均显著低于对照组,差异有统计学意义(P<0.05).结论 对于SS患者,采用CRRT联合乌司他丁治疗,能够显著改善患者的炎症状态和凝血功能,降低病死率.
Abstract
Objective To investigate the efficacy of ulinastatin supplemented with continuous renal replacement therapy(CRRT)in the treatment of severe sepsis(SS).Methods A total of 72 patients with SS admitted to hospital from April 2022 to December 2023 were selected as the research object,and the patients were randomly divided into two groups based on the principle of equalization of baseline data between groups,36 cases in each group.The control group was given CRRT,and the observation group was given ulinastatin on the basis of the control group,both of which continued for one week.The inflammatory factors[procalcitonin(PCT),C-reactive protein(CRP)and interleukin-6(IL-6)],coagulation function[activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT)and blood platelet count(PLT)],acute phy siology and chronic health evaluation Ⅱ(APACHEⅡ)scale and sequential organ failure assessment(SOFA)were compared before and after treatment,and incidence of disseminated intravascular coagulation(DIC),multiple organ dysfunction(MODS)and mortality in the two groupsscores were calculated.Results After 7 days of treatment,the levels of PCT,CRP and IL-6 in the observation group were significantly lower than those in the control group(P<0.05).After 7 days of treatment,the levels of APTT,PT and TT in the observation group were lower than those in the control group,while the level of PLT was higher than that in the control group(P<0.05).After 7 days of treatment,APACHEⅡ score and SOFA score in the observation group were lower than those in the control group(P<0.05).The incidence of DIC,MODS and mortality in the observation group were significantly lower than those in the control group(P<0.05).Conclusion For SS patients,CRRT combined with ulinastatin can significantly improve the inflammatory state and coagulation function of patients and reduce the mortality.
关键词
连续性肾脏替代疗法/乌司他丁/严重脓毒症/凝血功能/炎性因子Key words
Continuous renal replacement therapy/Ulinastatin/Severe sepsis/Clotting function/Inflammatory factors引用本文复制引用
基金项目
安徽省高等学校重点科研项目(2023AH052424)
阜阳职业技术学院成果培育转化项目(2022KYXM17)
出版年
2024
NETL
NSTL
万方数据