Observation of therapeutic effect of meropenem injection combined with ulinastatin on septic shock
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目的 分析美罗培南注射剂联合乌司他丁治疗脓毒症休克的效果。 方法 随机对照研究。抽取2019年3月至2023年2月郑州人民医院收治的60例脓毒症休克患者为研究对象，基于简单随机化法分为联合组与对照组，每组30例。对照组采用美罗培南注射剂治疗，联合组采用美罗培南注射剂联合乌司他丁治疗。比较两组疗效、心肌功能[脑钠肽、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)]、肝功能[天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆红素(TBiL)]、肾功能[血肌酐、尿素氮、中性粒细胞明胶酶相关脂质转运蛋白(NGAL)]、血清炎症因子[血清淀粉样蛋白A(SAA)、肝素结合蛋白(HBP)、C反应蛋白(CRP)]水平、多器官功能障碍综合征(MODS)发生率。 结果 联合组总有效率(96.67%，29/30)高于对照组(73.33%，22/30)，P<0.05。治疗后，联合组脑钠肽、CK-MB、cTnI水平低于对照组(P<0.05)。治疗后，联合组AST、ALT、TBiL水平低于对照组(P<0.05)。治疗后，联合组血肌酐、尿素氮、NGAL水平低于对照组(P<0.05)。治疗后，联合组SAA、HBP、CRP水平低于对照组(P<0.05)。联合组MODS发生率(6.67%，2/30)低于对照组(26.67%，8/30)，P<0.05。 结论 美罗培南注射剂联合乌司他丁治疗脓毒症休克可提高疗效，减轻心肌功能、肝肾功能损害，并能减轻炎症反应，降低MODS发生率。 Objective To analyze the effect of meropenem injection combined with ulinastatin in the treatment of septic shock. Methods This study was a randomized controlled trail. A total of 60 patients with septic shock treated in People’s Hospital of Zhengzhou from March 2019 to February 2023 were selected as research objects. And they were divided into combined group and control group according to simple randomization method, with 30 cases in each group. The control group was treated with meropenem injection, and the combined group was treated with meropenem injection combined with ulinastatin. The curative effect, myocardial function assessed by brain natriuretic peptide, creatine kinase isoenzymes (CK-MB) and cardiac troponin I (cTnI), liver function assessed by aspartate transaminase (AST), alanine aminotransferase (ALT) and total bilirubin (TBiL), renal function assessed by serum creatinine (Scr), blood urea nitrogen (BUN) and neutrophil gelatinase associated lipocalin (NGAL), levels of serum inflammatory factors, including serum amyloid A (SAA), heparin-binding protein (HBP) and C-reactive protein (CRP), and incidence of multiple organ dysfunction syndrome (MODS) were compared between the two groups. Results The total effective rate of the combined group (96.67%, 29/30) was higher than that of the control group (73.33%, 22/30), P<0.05. After treatment, the levels of BNP, CK-MB and cTnI in the combined group were lower than those in the control group (P<0.05). After treatment, levels of AST, ALT and TBiL in the combined group were lower than those in the control group (P<0.05). After treatment, levels of serum creatinine, blood urea nitrogen and NGAL in the combined group were lower than those in the control group (P<0.05). After treatment, the levels of SAA, HBP and CRP in the combined group were lower than those in the control group (P<0.05). The incidence of MODS in the combined group was 6.67% (2/30), lower than 26.67% (8/30) in the control group (P<0.05). Conclusions Meropenem injection combined with ulinastatin in the treatment of septic shock can improve the treatment efficacy, reduce impair on myocardial function, liver function and kidney function, reduce inflammatory response, and decrease the incidence of MODS.
Objective To analyze the effect of meropenem injection combined with ulinastatin in the treatment of septic shock. Methods This study was a randomized controlled trail. A total of 60 patients with septic shock treated in People’s Hospital of Zhengzhou from March 2019 to February 2023 were selected as research objects. And they were divided into combined group and control group according to simple randomization method, with 30 cases in each group. The control group was treated with meropenem injection, and the combined group was treated with meropenem injection combined with ulinastatin. The curative effect, myocardial function assessed by brain natriuretic peptide, creatine kinase isoenzymes (CK-MB) and cardiac troponin I (cTnI), liver function assessed by aspartate transaminase (AST), alanine aminotransferase (ALT) and total bilirubin (TBiL), renal function assessed by serum creatinine (Scr), blood urea nitrogen (BUN) and neutrophil gelatinase associated lipocalin (NGAL), levels of serum inflammatory factors, including serum amyloid A (SAA), heparin-binding protein (HBP) and C-reactive protein (CRP), and incidence of multiple organ dysfunction syndrome (MODS) were compared between the two groups. Results The total effective rate of the combined group (96.67%, 29/30) was higher than that of the control group (73.33%, 22/30), P<0.05. After treatment, the levels of BNP, CK-MB and cTnI in the combined group were lower than those in the control group (P<0.05). After treatment, levels of AST, ALT and TBiL in the combined group were lower than those in the control group (P<0.05). After treatment, levels of serum creatinine, blood urea nitrogen and NGAL in the combined group were lower than those in the control group (P<0.05). After treatment, the levels of SAA, HBP and CRP in the combined group were lower than those in the control group (P<0.05). The incidence of MODS in the combined group was 6.67% (2/30), lower than 26.67% (8/30) in the control group (P<0.05). Conclusions Meropenem injection combined with ulinastatin in the treatment of septic shock can improve the treatment efficacy, reduce impair on myocardial function, liver function and kidney function, reduce inflammatory response, and decrease the incidence of MODS.
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