乌司他丁在创伤失血性休克治疗中的研究进展
摘要
创伤失血性休克是交通事故和工业外伤等患者死亡的常见原因,加重了有限医疗资源的负担,对人类健康和经济也造成了巨大的威胁。乌司他丁是从人尿液中提取、纯化而来的尿胰蛋白酶抑制剂,具有阻断炎症级联反应、保护内皮细胞、降低血管通透性、改善微循环等作用,主要用于胰腺炎、脓毒症及休克等治疗。本文就近年来乌司他丁在创伤失血性休克治疗中的研究进展作一简单综述。
引文
[1]刘明华,赵晓东,于学忠.创伤失血性休克诊治中国急诊专家共识[J].中华急诊医学杂志,2017,26(12):1358-1365.
[2]Almahmoud K,Namas RA,Abdul-Malak O,et al.Impact of Injury Severity on Dynamic Inflammation Networks Following Blunt Trauma.Shock(Augusta,Ga).2015,44(2):101-109.
[3]Chen G,You G,Wang Y,et al.Effects of synthetic colloids on oxidative stress and inflammatory response in hemorrhagic shock:comparison of hydroxyethyl starch 130/0.4,hydroxyethyl starch200/0.5,and succinylated gelatin[J].Critical Care,2013,17(4):R141.
[4]黄海东,沈裴庆,孙世琦.乌司他丁对外伤失血性休克的临床疗效及血清肿瘤坏死因子-α的影响[J].海南医学院学报,2014,20(8):1067-1070.
[5]孙贤杰,张新根,石钢,等.乌司他丁对高龄髋关节置换术患者术后凝血功能的影响[J].中国生化药物杂志,2017,37(6):155-157.
[6]金红利,彭明清.乌司他丁器官保护作用的研究进展[J].医学综述,2016,22(19):3832-3835.
[7]王维维,王耀丽,马剑飞,等.乌司他丁改善脓毒性休克患者肺血管通透性及复苏效果的临床研究[J].临床急诊杂志,2017(2):133-136.
[8]景炳文.乌司他丁在急危重症临床应用进展[J].中国危重病急救医学,2006(18):117-120.
[9]周建,迟春天,鲍永霞.乌司他丁对重症哮喘患者血浆中CRP、IL-8、IL-10、TNF-α水平的影响[J].国际呼吸杂志,2017(21):1630-1632.
[10]李树青,孙雪丽,万执勇,等.乌司他丁对重症肺炎患儿血清TNF-α、IL-6、IL-8、IL-10水平的影响[J].中国急救医学,2016(10):940-942.
[11]Liu W,Pang G,Wang S,et al.Protective effect of ulinastatin on severe pulmonary infection under immunosuppression and its molecular mechanism.[J].Experimental&Therapeutic Medicine,2017,14(4):3583.
[12]陈如康,吴伟,黄增峰,等.参麦注射液联合尿蛋白酶抑制剂对创伤脓毒症患者免疫调理的临床观察[J].中国中西医结合外科杂志,2017,23(4):349-352.
[13]赵小丹,刘浩,李涛,等.乌司他丁减轻老年大鼠髋部骨折后肺损伤程度的实验研究[J].四川大学学报(医学版),2017,48(6):869-872.
[14]Chen L,Xiaolin Q I,Chen Y.Effect of Ulinastatin on the expression of NF-κB and TNF-αin the rabbits with acute lung injury induced by underwater explosion[J].Journal of Bethune Medical Science,2017.
[15]Li D,Ji H,Zhao B,et al.Therapeutic effect of ulinastatin on pulmonary fibrosis via downregulation of TGFβ1,TNFαand NFκB.[J].Molecular Medicine Reports,2018,17(1):1717-1723.
[16]Cao C,Yin C,Shou S,et al.Ulinastatin protects against LPSinduced acute lung injury by attenuating TLR4/NF-κB pathway activation and reducing inflammatory mediators.[J].Shock,2018.
[17]华天凤,尹路,李惠,等.大剂量乌司他丁联合肺保护性通气对危重疾病合并急性肺损伤(ALI)/急性呼吸窘迫综合征(ARDS)患者呼吸功能的影响[J].中国循证医学杂志,2017(4):379-382.
[18]王力民,汤慧,郑亚伟.乌司他丁对创伤失血性休克患者TXA2/PGI2平衡和肾功能的影响[J].中国中西医结合外科杂志,2010,16(2):169-172.
[19]吴剑弟,梁健球,李琛.乌司他丁对急诊冠脉介入治疗患者肝肾功能的保护作用[J].实用医学杂志,2016,32(1):118-120.
[20]Xin W,Xie X,Gendoo Y,et al.Ulinastatin administration is associated with a lower incidence of acute kidney injury after cardiac surgery:a propensity score matched study[J].Critical Care,2016,20(1):42.
[21]Jing X,Yan Y,Hu C,et al.Ulinastatin improve kidney ischaemic due to cardiopulmonary resuscitation in rabbits[J].Heart,2012,98(14):E117-E117.
[22]Li X,Su L,Zhang X,et al.Ulinastatin downregulates TLR4 and NF-k B expression and protects mouse brains against ischemia/reperfusion injury[J].Neurological Research,2017,39(4):367-373.
[23]Li X F,Zhang X J,Zhang C,et al.Ulinastatin protects brain against cerebral ischemia/reperfusion injury through inhibiting MMP-9 and alleviating loss of ZO-1 and occludin proteins in mice[J].Experimental Neurology,2017,302:68-74.
[24]黄甫,陈杰,刘见希,等.乌司他丁治疗重型颅脑创伤后脑水肿的疗效观察[J].心脑血管病防治,2016,16(1):35-37.
[25]Jiang X M,Hu J H,Wang L L,et al.Effects of ulinastatin on global ischemia via brain pro-inflammationsignal[J].Translational Neuroscience,2016,7(1):158-163.
[26]Zhang Y,Zeng Z,Cao Y,et al.Effect of urinary protease inhibitor(ulinastatin)on cardiopulmonary bypass:a meta-analysis for china and Japan.[J].Plos One,2014,9(12):e113973.
[27]Li L,Hao J,Jiang X,et al.Cardioprotective effects of ulinastatin against isoproterenol-induced chronic heart failure through the PI3K Akt,p38 MAPK and NF-κB pathways[J].Molecular Medicine Reports,2017:1354-1360.
[28]王龙.乌司他丁对体外循环心脏手术患者心脏炎症状态的影响[J].天津医科大学学报,2017,23(5):446-448.
[29]Jian-Di W U,Liang J Q,Chen L I.Effects of ulinastatin in young and middle-aged patients with myocardial infarction and cardiac shock[J].Lingnan Journal of Emergency Medicine,2017.
[30]周丽,厉旭光,林贤考.乌司他丁对失血性休克患者肝肾功能的影响[J].中国药师,2015(3):424-426.
[31]姜远旭,夏明珠,丁登峰,等.乌司他丁对失血性休克/复苏-内毒素双重打击大鼠急性肝损伤的保护作用[J].中国急救医学,2016,36(12):1116-1120.
[32]吴治宇.乌司他丁对肝缺血-再灌注损伤患者肝功能和血浆一氧化氮/内皮素-1的影响[J].中国药业,2010,19(17):80-81.
[33]Chang L I,Han B,Lan N.The effect of ulinastatin on inflammatory response and liver function in elderly patients with cholelithiasis.[J].China Continuing Medical Education,2017.
[34]何健强,马勇,李毅,等.乌司他丁对低血容量性休克疗效的Meta分析[J].临床急诊杂志,2017(9):659-663.
[35]Yang B,Gao M,Wang K,et al.Intraintestinal administration of ulinastatin protects against sepsis by relieving intestinal damage.[J].Journal of Surgical Research,2017,211(5):70-78.
[36]陈永满,徐渭贤,孙立宝,等.乌司他丁联用生长抑素治疗新生儿消化道畸形术后消化道出血的有效性与安全性评价[J].河北医科大学学报,2017,38(11):1292-1294.
[37]王改,王志华,段红年,等.乌司他丁对过氧化氢诱导的肠上皮屏障损伤的保护作用[J].胃肠病学,2017,22(4):224-228.
[38]Zong Y,Wang Y,Zhang Y,et al.Early curative effect of ulinastatin in the treatment of systemic inflammatory reaction after traumatic hemorrhagic shock[J].Shaanxi Medical Journal,2017.
[39]赵品,高金鉴,张亚军,等.乌司他丁对创伤性休克患者肝脏和凝血功能影响的回顾性研究[J].国际麻醉学与复苏杂志,2016,37(4):297-302.
[2]Almahmoud K,Namas RA,Abdul-Malak O,et al.Impact of Injury Severity on Dynamic Inflammation Networks Following Blunt Trauma.Shock(Augusta,Ga).2015,44(2):101-109.
[3]Chen G,You G,Wang Y,et al.Effects of synthetic colloids on oxidative stress and inflammatory response in hemorrhagic shock:comparison of hydroxyethyl starch 130/0.4,hydroxyethyl starch200/0.5,and succinylated gelatin[J].Critical Care,2013,17(4):R141.
[4]黄海东,沈裴庆,孙世琦.乌司他丁对外伤失血性休克的临床疗效及血清肿瘤坏死因子-α的影响[J].海南医学院学报,2014,20(8):1067-1070.
[5]孙贤杰,张新根,石钢,等.乌司他丁对高龄髋关节置换术患者术后凝血功能的影响[J].中国生化药物杂志,2017,37(6):155-157.
[6]金红利,彭明清.乌司他丁器官保护作用的研究进展[J].医学综述,2016,22(19):3832-3835.
[7]王维维,王耀丽,马剑飞,等.乌司他丁改善脓毒性休克患者肺血管通透性及复苏效果的临床研究[J].临床急诊杂志,2017(2):133-136.
[8]景炳文.乌司他丁在急危重症临床应用进展[J].中国危重病急救医学,2006(18):117-120.
[9]周建,迟春天,鲍永霞.乌司他丁对重症哮喘患者血浆中CRP、IL-8、IL-10、TNF-α水平的影响[J].国际呼吸杂志,2017(21):1630-1632.
[10]李树青,孙雪丽,万执勇,等.乌司他丁对重症肺炎患儿血清TNF-α、IL-6、IL-8、IL-10水平的影响[J].中国急救医学,2016(10):940-942.
[11]Liu W,Pang G,Wang S,et al.Protective effect of ulinastatin on severe pulmonary infection under immunosuppression and its molecular mechanism.[J].Experimental&Therapeutic Medicine,2017,14(4):3583.
[12]陈如康,吴伟,黄增峰,等.参麦注射液联合尿蛋白酶抑制剂对创伤脓毒症患者免疫调理的临床观察[J].中国中西医结合外科杂志,2017,23(4):349-352.
[13]赵小丹,刘浩,李涛,等.乌司他丁减轻老年大鼠髋部骨折后肺损伤程度的实验研究[J].四川大学学报(医学版),2017,48(6):869-872.
[14]Chen L,Xiaolin Q I,Chen Y.Effect of Ulinastatin on the expression of NF-κB and TNF-αin the rabbits with acute lung injury induced by underwater explosion[J].Journal of Bethune Medical Science,2017.
[15]Li D,Ji H,Zhao B,et al.Therapeutic effect of ulinastatin on pulmonary fibrosis via downregulation of TGFβ1,TNFαand NFκB.[J].Molecular Medicine Reports,2018,17(1):1717-1723.
[16]Cao C,Yin C,Shou S,et al.Ulinastatin protects against LPSinduced acute lung injury by attenuating TLR4/NF-κB pathway activation and reducing inflammatory mediators.[J].Shock,2018.
[17]华天凤,尹路,李惠,等.大剂量乌司他丁联合肺保护性通气对危重疾病合并急性肺损伤(ALI)/急性呼吸窘迫综合征(ARDS)患者呼吸功能的影响[J].中国循证医学杂志,2017(4):379-382.
[18]王力民,汤慧,郑亚伟.乌司他丁对创伤失血性休克患者TXA2/PGI2平衡和肾功能的影响[J].中国中西医结合外科杂志,2010,16(2):169-172.
[19]吴剑弟,梁健球,李琛.乌司他丁对急诊冠脉介入治疗患者肝肾功能的保护作用[J].实用医学杂志,2016,32(1):118-120.
[20]Xin W,Xie X,Gendoo Y,et al.Ulinastatin administration is associated with a lower incidence of acute kidney injury after cardiac surgery:a propensity score matched study[J].Critical Care,2016,20(1):42.
[21]Jing X,Yan Y,Hu C,et al.Ulinastatin improve kidney ischaemic due to cardiopulmonary resuscitation in rabbits[J].Heart,2012,98(14):E117-E117.
[22]Li X,Su L,Zhang X,et al.Ulinastatin downregulates TLR4 and NF-k B expression and protects mouse brains against ischemia/reperfusion injury[J].Neurological Research,2017,39(4):367-373.
[23]Li X F,Zhang X J,Zhang C,et al.Ulinastatin protects brain against cerebral ischemia/reperfusion injury through inhibiting MMP-9 and alleviating loss of ZO-1 and occludin proteins in mice[J].Experimental Neurology,2017,302:68-74.
[24]黄甫,陈杰,刘见希,等.乌司他丁治疗重型颅脑创伤后脑水肿的疗效观察[J].心脑血管病防治,2016,16(1):35-37.
[25]Jiang X M,Hu J H,Wang L L,et al.Effects of ulinastatin on global ischemia via brain pro-inflammationsignal[J].Translational Neuroscience,2016,7(1):158-163.
[26]Zhang Y,Zeng Z,Cao Y,et al.Effect of urinary protease inhibitor(ulinastatin)on cardiopulmonary bypass:a meta-analysis for china and Japan.[J].Plos One,2014,9(12):e113973.
[27]Li L,Hao J,Jiang X,et al.Cardioprotective effects of ulinastatin against isoproterenol-induced chronic heart failure through the PI3K Akt,p38 MAPK and NF-κB pathways[J].Molecular Medicine Reports,2017:1354-1360.
[28]王龙.乌司他丁对体外循环心脏手术患者心脏炎症状态的影响[J].天津医科大学学报,2017,23(5):446-448.
[29]Jian-Di W U,Liang J Q,Chen L I.Effects of ulinastatin in young and middle-aged patients with myocardial infarction and cardiac shock[J].Lingnan Journal of Emergency Medicine,2017.
[30]周丽,厉旭光,林贤考.乌司他丁对失血性休克患者肝肾功能的影响[J].中国药师,2015(3):424-426.
[31]姜远旭,夏明珠,丁登峰,等.乌司他丁对失血性休克/复苏-内毒素双重打击大鼠急性肝损伤的保护作用[J].中国急救医学,2016,36(12):1116-1120.
[32]吴治宇.乌司他丁对肝缺血-再灌注损伤患者肝功能和血浆一氧化氮/内皮素-1的影响[J].中国药业,2010,19(17):80-81.
[33]Chang L I,Han B,Lan N.The effect of ulinastatin on inflammatory response and liver function in elderly patients with cholelithiasis.[J].China Continuing Medical Education,2017.
[34]何健强,马勇,李毅,等.乌司他丁对低血容量性休克疗效的Meta分析[J].临床急诊杂志,2017(9):659-663.
[35]Yang B,Gao M,Wang K,et al.Intraintestinal administration of ulinastatin protects against sepsis by relieving intestinal damage.[J].Journal of Surgical Research,2017,211(5):70-78.
[36]陈永满,徐渭贤,孙立宝,等.乌司他丁联用生长抑素治疗新生儿消化道畸形术后消化道出血的有效性与安全性评价[J].河北医科大学学报,2017,38(11):1292-1294.
[37]王改,王志华,段红年,等.乌司他丁对过氧化氢诱导的肠上皮屏障损伤的保护作用[J].胃肠病学,2017,22(4):224-228.
[38]Zong Y,Wang Y,Zhang Y,et al.Early curative effect of ulinastatin in the treatment of systemic inflammatory reaction after traumatic hemorrhagic shock[J].Shaanxi Medical Journal,2017.
[39]赵品,高金鉴,张亚军,等.乌司他丁对创伤性休克患者肝脏和凝血功能影响的回顾性研究[J].国际麻醉学与复苏杂志,2016,37(4):297-302.