乌司他丁对急性重症脑出血致全身炎症反应综合征的疗效及作用机制研究

doi:10.3969/j.issn.1002-1949.2017.12.015

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摘要目的: 评价乌司他丁治疗急性重症脑出血所致全身炎症反应综合征(systemic inflammatory response syndrome, SIRS)患者的临床疗效、安全性及其作用机制。方法: 将急性重症脑出血所致SIRS，且未行手术治疗的100例患者随机分为治疗组和对照组各50例，两组均给予相同的常规治疗，治疗组加用乌司他丁，对照组给予等量生理盐水作为对照，治疗前后测定患者血清肿瘤坏死因子-α(TNF-α)、白细胞介素（IL）-1、IL-6。结果: 乌司他丁治疗组患者治疗第1、7天的血清TNF-α［（9.65±3.72)pg/mL，(6.82±4.64）pg/mL］、IL-1［（5.33±2.36)pg/mL，(3.62±2.56）pg/mL］、IL-6［（11.65±5.67)pg/mL，(8.52±4.85）pg/mL］均明显低于对照组(P＜0.05)；治疗组患者治疗后7、28 d NIHSS评分［（14.5±5.2）分,（12.1±5.4）分］及MODS的发生率（40.8%, 66.6%）均明显低于对照组(P＜0.05)。结论: 乌司他丁能够有效降低重症脑出血所致SIRS患者的血清TNF-α、IL-1、IL-6水平，从而降低多器官功能障碍综合征（MODS）的发生率，改善预后。

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	李建国
	郭伟
	单凯
	徐玢
	杨铁城
	董小燕
	陈必耀
	杜涵洋
	郝峰
	穆洪

收稿日期: 2017-08-25

基金资助:北京市东城区科委2016年计划项目（2016-3-005）

通讯作者: 郭伟（1972-），男，博士，主任医师，科主任，E-mail:guowei1010@126.com

作者简介: 李建国（1976-），男，副主任医师，E-mail:13681488500@163.com

引用本文:

李建国，郭伟，单凯，徐玢，杨铁城，董小燕，陈必耀，杜涵洋，郝峰，穆洪. 乌司他丁对急性重症脑出血致全身炎症反应综合征的疗效及作用机制研究[J]. 中国急救医学, 2017, 37(12): 1139-1142.
Li Jian-guo, Guo Wei, Shan Kai, Xu Bin, Yang Tie-cheng, Dong Xiao-yan, Chen Bi-yao, Du Han-yang, Hao Feng, Mu Hong. Efficacy and mechanism of action of ulinastatin for treatment of systemic inflammatory response syndrome associated with acute severe cerebral hemorrhage. Chinese Journal of Critical Care Medicine, 2017, 37(12): 1139-1142.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2017.12.015 或 http://www.cnemergency.org.cn/CN/Y2017/V37/I12/1139

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