乌司他丁辅助激素治疗小儿脓毒症疗效分析
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摘要
目的 探究乌司他丁辅助肾上腺皮质激素治疗小儿脓毒症疗效。方法 选取浙江省永康市第一人民医院2016年1月至2018年5月收治的140例脓毒症患儿,采用随机数字表法将患儿分为观察组(n=70)和对照组(n=70)。对照组患儿采用常规治疗(抗生素及其他常规辅助治疗和处理);观察组在对照组的基础上,加用乌司他丁联合小剂量糖皮质激素进行治疗。对比两组患儿治疗前后体温、心率、白细胞计数、肝肾功能和凝血功能的情况。结果 治疗后,观察组患儿体温(36.71±0.33)℃、心率(108.62±10.04)次/分、白细胞计数(8.50±0.51)×10~9/L均低于对照组患儿体温(37.43±0.23)℃、心率(127.42±9.79)次/分、白细胞计数(10.23±0.67)×10~9/L(t值分别为16.24、11.29、18.20,均P<0.05),观察组患儿丙氨酸转氨酶(39.12±9.42)U/L、天冬氨酸转氨酶(90.80±11.73)IU/L、肌酐(75.82±10.41)μmol/L、尿素氮(6.90±1.45)mmo/L均低于对照组患儿丙氨酸转氨酶(87.61±11.20)U/L、天冬氨酸转氨酶(129.53±16.94)IU/L、肌酐(107.65±9.31)mol/L、尿素氮(6.93±1.46)μmol/L,组间比较差异有统计学意义(t值分别为27.75、15.75、19.06、9.16,均P<0.05)。治疗后,观察组血小板(PLT)、纤维蛋白原(FIB)[(152.79±31.62)×10~9/L、(3.69±0.52g/L)]高于对照组[(112.96±38.64)×10~9/L、(2.67±0.75g/L)],而血酶原时间(PT)、活化部分凝血酶原时间(APTT)[(12.30±1.31)s、(33.05±3.34)s]低于对照组[(16.91±1.73)s、(39.84±8.67)s],差异有统计学意义(t值分别为6.67、9.36、17.80、6.12,均P<0.05)。结论 乌司他丁辅助肾上腺皮质激素治疗小儿脓毒症,可有效改善患儿临床症状和各项指标,具有较高临床价值。
Objective To explore the therapeutic effect of ulinastatin-assisted adrenal cortex hormone on children with sepsis. Methods Totally 140 children with sepsis admitted to Yongkang First People's Hospital were selected from January 2016 to May 2018, and they were divided into observation group(n=70) and control group(n=70) by random number table method. The control group was treated with conventional therapy(antibiotics and other auxiliary therapy), and the observation group was provided with ulinastatin-assisted adrenal cortex hormone based on the treatment for the control group. The temperature, heart rate, white blood cell count and liver and kidney function of two groups before and after treatment were compared. Results After treatment, the body temperature(36.71±0.33℃), heart rate(108.62±10.04 bpm) and white blood cell count [(108.62±10.04)×10~9/L] of the observation group were all lower than those of the control group [(37.43±0.23℃),(127.42±9.79 bpm) and(10.23±0.67)×10~9/L](t value was 16.24, 11.29 and 18.20, respectively, all P<0.05). Alanine aminotransferase(39.12±9.42 U/L), aspartate aminotransferase(90.80±11.73 IU/L), creatinine(75.82±10.41 μmol/L) and urea nitrogen(6.90±1.45μmol/L) in the observation group were all significantly lower than those in the control group [(87.61±11.20 IU/L),(129.53±16.94 IU/L),(107.65±9.31 μmol/L) and(6.93±1.46μmol/L)](t value was 27.75, 15.75, 19.06 and 9.16, respectively, all P<0.05). After treatment, platelet(PLT), fibrinogen(FIB) [(152.79±31.62)×10~9/L, 3.69±0.52 g/L] in the observation group were higher than those in the control group [(112.96±38.64)×10~9/L,2.67±0.75 g/L], while prothrombin time(PT), activated partial thrombin time(APTT)(12.30±1.31 s, 33.05±3.34 s) were significantly lower than those in the control group(16.91±1.73 s, 39.84±8.67 s)(t value was 6.67, 9.36, 17.80 and 6.12, respectively, all P<0.05). Conclusion Ulinastatin-assisted adrenal cortex hormone can effectively improve the clinical symptoms and indicators of children with sepsis, which is of high clinical value.
Objective To explore the therapeutic effect of ulinastatin-assisted adrenal cortex hormone on children with sepsis. Methods Totally 140 children with sepsis admitted to Yongkang First People's Hospital were selected from January 2016 to May 2018, and they were divided into observation group(n=70) and control group(n=70) by random number table method. The control group was treated with conventional therapy(antibiotics and other auxiliary therapy), and the observation group was provided with ulinastatin-assisted adrenal cortex hormone based on the treatment for the control group. The temperature, heart rate, white blood cell count and liver and kidney function of two groups before and after treatment were compared. Results After treatment, the body temperature(36.71±0.33℃), heart rate(108.62±10.04 bpm) and white blood cell count [(108.62±10.04)×10~9/L] of the observation group were all lower than those of the control group [(37.43±0.23℃),(127.42±9.79 bpm) and(10.23±0.67)×10~9/L](t value was 16.24, 11.29 and 18.20, respectively, all P<0.05). Alanine aminotransferase(39.12±9.42 U/L), aspartate aminotransferase(90.80±11.73 IU/L), creatinine(75.82±10.41 μmol/L) and urea nitrogen(6.90±1.45μmol/L) in the observation group were all significantly lower than those in the control group [(87.61±11.20 IU/L),(129.53±16.94 IU/L),(107.65±9.31 μmol/L) and(6.93±1.46μmol/L)](t value was 27.75, 15.75, 19.06 and 9.16, respectively, all P<0.05). After treatment, platelet(PLT), fibrinogen(FIB) [(152.79±31.62)×10~9/L, 3.69±0.52 g/L] in the observation group were higher than those in the control group [(112.96±38.64)×10~9/L,2.67±0.75 g/L], while prothrombin time(PT), activated partial thrombin time(APTT)(12.30±1.31 s, 33.05±3.34 s) were significantly lower than those in the control group(16.91±1.73 s, 39.84±8.67 s)(t value was 6.67, 9.36, 17.80 and 6.12, respectively, all P<0.05). Conclusion Ulinastatin-assisted adrenal cortex hormone can effectively improve the clinical symptoms and indicators of children with sepsis, which is of high clinical value.
引文
[1]贺小丽,李德渊,乔莉娜,等.脓毒症流行病学及预后的研究进展[J].中华危重病急救医学,2018,30(5):486-489.
[2] 孙小聪,邵义明,黄河,等.乌司他丁对脓毒症急性肾损伤肾功能的保护作用[J].中华实验外科杂志,2015,32(4):910-912.
[3] Motzkus C A,Chrysanthopoulou S A,Luckmann R,et al.ICU Admission Source as a Predictor of Mortality for Patients With Sepsis[J].J Intensive Care Med,2018,33 (9):510-516.
[4] 樊楚明,杨欣悦,任靖宇,等.乌司他丁对脓毒症大鼠血管内皮细胞损伤保护作用及机制研究[J].中国临床药理学杂志,2016,32(8):723-726.
[5] 陶广华,张随随,朱玲钰,等.乌司他丁的药理作用机制及临床应用进展[J].中国药房,2017,28(35):5020-5023.
[6] 张璐璐,陈亮,杜丽,等.乌司他丁联合参麦注射液治疗创伤后早期急性肺损伤疗效及对血清TNF-α、IL-6水平的影响[J].现代生物医学进展,2017,(33):6540-6543.
[7] 陈伟,李小波,梁英平.含乌司他丁自体冷血心脏停搏液对保护心肌细胞的分析[J].中国妇幼健康研究,2017,28 (12):1748-1750.
[8] 樊敬峰.乌司他丁在重症急性脑血管病伴凝血功能异常患者中的应用[J].卒中与神经疾病,2018,25(3):124-126.
[2] 孙小聪,邵义明,黄河,等.乌司他丁对脓毒症急性肾损伤肾功能的保护作用[J].中华实验外科杂志,2015,32(4):910-912.
[3] Motzkus C A,Chrysanthopoulou S A,Luckmann R,et al.ICU Admission Source as a Predictor of Mortality for Patients With Sepsis[J].J Intensive Care Med,2018,33 (9):510-516.
[4] 樊楚明,杨欣悦,任靖宇,等.乌司他丁对脓毒症大鼠血管内皮细胞损伤保护作用及机制研究[J].中国临床药理学杂志,2016,32(8):723-726.
[5] 陶广华,张随随,朱玲钰,等.乌司他丁的药理作用机制及临床应用进展[J].中国药房,2017,28(35):5020-5023.
[6] 张璐璐,陈亮,杜丽,等.乌司他丁联合参麦注射液治疗创伤后早期急性肺损伤疗效及对血清TNF-α、IL-6水平的影响[J].现代生物医学进展,2017,(33):6540-6543.
[7] 陈伟,李小波,梁英平.含乌司他丁自体冷血心脏停搏液对保护心肌细胞的分析[J].中国妇幼健康研究,2017,28 (12):1748-1750.
[8] 樊敬峰.乌司他丁在重症急性脑血管病伴凝血功能异常患者中的应用[J].卒中与神经疾病,2018,25(3):124-126.