高剂量与常规剂量乌司他丁联合血必净治疗脓毒症的临床疗效分析

夏胜兵; 张国秀

doi:10.16016/j.1000-5404.201801249

您当前的位置：

首页 >

文章列表页 >

高剂量与常规剂量乌司他丁联合血必净治疗脓毒症的临床疗效分析

临床医学 | 更新时间：2026-01-09

- 高剂量与常规剂量乌司他丁联合血必净治疗脓毒症的临床疗效分析
- Clinical efficacy of high versus regular dose of ulinastatin combined with Xuebijing for treatment of sepsis
- 第三军医大学学报 2018年40卷第16期页码：1512-1517
- 作者机构：
- 作者简介：
- 基金信息：
  
  河南省医学科技攻关计划项目(201504010)
- DOI：10.16016/j.1000-5404.201801249
  中图分类号：
- 收稿：2018-01-31，
  
  纸质出版：2018-08-30
- 稿件说明：
移动端阅览
夏胜兵, 张国秀. 高剂量与常规剂量乌司他丁联合血必净治疗脓毒症的临床疗效分析[J]. 第三军医大学学报, 2018,40(16):1512-1517.

Shengbing XIA, Guoxiu ZHANG. Clinical efficacy of high versus regular dose of ulinastatin combined with Xuebijing for treatment of sepsis[J]. Journal of Third Military Medical University, 2018, 40(16): 1512-1517.
夏胜兵, 张国秀. 高剂量与常规剂量乌司他丁联合血必净治疗脓毒症的临床疗效分析[J]. 第三军医大学学报, 2018,40(16):1512-1517. DOI： 10.16016/j.1000-5404.201801249.

Shengbing XIA, Guoxiu ZHANG. Clinical efficacy of high versus regular dose of ulinastatin combined with Xuebijing for treatment of sepsis[J]. Journal of Third Military Medical University, 2018, 40(16): 1512-1517. DOI： 10.16016/j.1000-5404.201801249.

摘要

Abstract

Objective

To compare the efficacy of high-dose versus regular-dose ulinastatin (UTI) combined with Xuebijing in the treatment of sepsis.

Methods

This randomized controlled trial was conducted in 150 patients (including 86 male and 64 female patients with a mean age of 41.7±5.1 years) admitted with the diagnosis of sepsis in our 2 hospitas between May

2016 and May

2017.The patients were randomized to receive routine treatment (control group) or UTI treatment at a regular (5 000 U·kg

-1

·d

-1

) or a high dose (25 000 U·kg

-1

·d

-1

) combined with daily intravenous infusion of 200 mL Xuebijing.At 0

and 7 d of treatment

the patients were examined for levels of TNF-α

IL-6

C-reactive protein (CRP)

procalcitonin (PCT)

CD4

and CD8

cells

PaO

PaCO

Lac

arterial oxygen partial pressure (A-aDO

)

cardiac functions

and peripheral vascular resistance (SVR); APACHE-Ⅱ score

mechanical ventilation time

ICU stay and the mortality rate at 28 d were also recorded in these patients.

Results

The 3 groups were comparable for the baseline parameters before the treatment (

0.05).Compared with the regular dose group

the patients receiving high-dose UTI treatment showed significantly decreased levels of TNF-α

IL-6

CRP

and PCT

increased CD4

and CD8

cell percentages and CD4

/CD8

ratio (

0.05)

and improved PaO

PaCO

Lac

A-aDO

and SVR (

0.05).Treatment with high-dose UTI was associated with a shortened mechanical ventilation time and ICU stay and significant reductions in APACHE-Ⅱ score and mortality rate at 28 days (

0.05).

Conclusion

Treatment with UTI combined with Xuebijing can significantly improve the clinical symptoms and the prognosis of sepsis

and a high dose of UTI can produce better protective effects.

关键词

Keywords

references

SINGER M DEUTSCHMAN C S SEYMOUR C W The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) JAMA 2016 315 8 801 810 10.1001/jama.2016.0287 SINGER M, DEUTSCHMAN C S, SEYMOUR C W, et al . The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)[J ] . JAMA, 2016, 315(8): 801-810. DOI: 10.1001/jama.2016.0287.

MAYR F B YENDE S ANGUS D C Epidemiology of severe sepsis Virulence 2013 5 1 4 11 10.4161/viru.27372 MAYR F B, YENDE S, ANGUS D C. Epidemiology of severe sepsis[J]. Virulence, 2013, 5(1): 4-11. DOI: 10.4161/viru.27372.

SOGAYAR A M MACHADO F R REA-NETO A A multicentre, prospective study to evaluate costs of septic patients in brazilian intensive care units Pharmacoeconomics 2008 26 5 425 434 10.2165/00019053-200826050-00006 SOGAYAR A M, MACHADO F R, REA-NETO A, et al . A multicentre, prospective study to evaluate costs of septic patients in brazilian intensive care units[J ] . Pharmacoeconomics, 2008, 26(5): 425-434. DOI: 10.2165/00019053-200826050-00006.

史晓峰王勇强血必净联合乌司他丁治疗百草枯中毒的效果观察中华劳动卫生职业病杂志 2015 33 5 375 377 10.3760/cma.j.issn.1001-9391.2015.05.017 史晓峰, 王勇强.血必净联合乌司他丁治疗百草枯中毒的效果观察[J].中华劳动卫生职业病杂志, 2015, 33(5): 375-377. DOI: 10.3760/cma.j.issn.1001-9391.2015.05.017.

SI X F WANG Y Q Observation of the effect of Xuebijing combined with ulinastatin in the treatment of paraquat poisoning Chin J Ind Hyg Occup Dis 2015 33 5 375 377 10.3760/cma.j.issn.1001-9391.2015.05.017 SI X F, WANG Y Q. Observation of the effect of Xuebijing combined with ulinastatin in the treatment of paraquat poisoning[J]. Chin J Ind Hyg Occup Dis, 2015, 33(5): 375-377. DOI: 10.3760/cma.j.issn.1001-9391.2015.05.017.

潘登孙跃女乌司他丁联合血必净对重症急性胰腺炎患者血清白细胞介素8和干扰素γ的影响中国综合临床 2015 31 5 443 445 10.3760/cma.j.issn.1008-6315.2015.05.020 潘登, 孙跃女.乌司他丁联合血必净对重症急性胰腺炎患者血清白细胞介素8和干扰素γ的影响[J].中国综合临床, 2015, 31(5): 443-445. DOI: 10.3760/cma.j.issn.1008-6315.2015.05.020.

PAN D SUN Y N Effects of ulinastatin and Xuebijing on serum interleukin 8 and interferon gamma in patients with severe acute pancreatitis Clin Med Chin 2015 31 5 443 445 10.3760/cma.j.issn.1008-6315.2015.05.020 PAN D, SUN Y N. Effects of ulinastatin and Xuebijing on serum interleukin 8 and interferon gamma in patients with severe acute pancreatitis[J]. Clin Med Chin, 2015, 31(5): 443-445. DOI: 10.3760/cma.j.issn.1008-6315.2015.05.020.

唐虹乌司他丁、血必净联合治疗对烧伤后脓毒症凝血功能及全身炎性反应影响的临床研究中国医科大学学报 2015 44 12 1132 1136 http://d.old.wanfangdata.com.cn/Periodical/zgykdxxb201512019 唐虹.乌司他丁、血必净联合治疗对烧伤后脓毒症凝血功能及全身炎性反应影响的临床研究[J].中国医科大学学报, 2015, 44(12): 1132-1136.

TANG H The clinical study of the effect of ulinastatin and Xuebijing on the coagulation and systemic inflammatory response of postburn sepsis J Chin Med Univ 2015 44 12 1132 1136 http://d.old.wanfangdata.com.cn/Periodical/zgykdxxb201512019 TANG H. The clinical study of the effect of ulinastatin and Xuebijing on the coagulation and systemic inflammatory response of postburn sepsis[J]. J Chin Med Univ, 2015, 44(12): 1132-1136.

崔文华代献科乌司他丁联合血必净治疗烧伤脓毒症的临床效果观察潍坊医学院学报 2016 38 4 319 320 10.16846/j.issn.1004-3101.2016.04.026 崔文华, 代献科.乌司他丁联合血必净治疗烧伤脓毒症的临床效果观察[J].潍坊医学院学报, 2016, 38(4): 319- 320. DOI: 10. 16846/j.issn.1004-3101.2016.04.026.

CUI W H DAI X K The clinical effect of ulinastatin combined with Xuebijing in the treatment of burn sepsis Acta Academiae Med Weifang 2016 38 4 319 320 10.16846/j.issn.1004-3101.2016.04.026 CUI W H, DAI X K. The clinical effect of ulinastatin combined with Xuebijing in the treatment of burn sepsis[J]. Acta Academiae Med Weifang, 2016, 38(4): 319-320. DOI: 10. 16846/j.issn.1004-3101.2016.04.026.

王瑞雪血必净联合乌司他丁治疗重症脓毒症的疗效观察临床医学研究与实践 2016 1 4 12 http://d.old.wanfangdata.com.cn/Periodical/lcyxyjysj201604006 王瑞雪.血必净联合乌司他丁治疗重症脓毒症的疗效观察[J].临床医学研究与实践, 2016, 1(4): 12.

WANG R X Observation of the curative effect of Xuebijing combined with ulinastatin in the treatment of severe sepsis Clin Med Res Prac 2016 1 4 12 http://d.old.wanfangdata.com.cn/Periodical/lcyxyjysj201604006 WANG R X. Observation of the curative effect of Xuebijing combined with ulinastatin in the treatment of severe sepsis[J]. Clin Med Res Prac, 2016, 1(4): 12.

CHEN Q HU C LIU Y Safety and tolerability of high-dose ulinastatin after 2-hour intravenous infusion in adult healthy Chinese volunteers: A randomized, double-blind, placebo-controlled, ascending-dose study PLoS ONE 2017 12 5 e0177425 10.1371/journal.pone.0177425 CHEN Q, HU C, LIU Y, et al . Safety and tolerability of high-dose ulinastatin after 2-hour intravenous infusion in adult healthy Chinese volunteers: A randomized, double-blind, placebo-controlled, ascending-dose study[J ] . PLoS ONE, 2017, 12(5): e0177425. DOI: 10.1371/journal.pone.0177425.

刘阳王茜赵慧颖乌司他丁在中国健康成年受试者中的耐受性研究中国临床药理学杂志 2015 31 21 2111 2113 10.13699/j 刘阳, 王茜, 赵慧颖, 等.乌司他丁在中国健康成年受试者中的耐受性研究[J].中国临床药理学杂志, 2015, 31(21): 2111-2113. DOI: 10. 13699 /j.

LIU Y WANG X ZHAO H Y Study on the tolerance of ulinastatin in Chinese healthy adult subjects Chin J Clin Pharmac 2015 31 21 2111 2113 10.13699/j.cnki.1001-6821.2015.21.008 cnki. 1001-6821. 2015. 21. 008. LIU Y, WANG X, ZHAO H Y, et al . Study on the tolerance of ulinastatin in Chinese healthy adult subjects[J ] . Chin J Clin Pharmac, 2015, 31(21): 2111-2113. DOI:10.13699/j.cnki. 1001-6821.2015.21.008.

周红刘鑫郑江脓毒症治疗——挑战与机遇并存第三军医大学学报 2013 35 2 91 94 http://aammt.tmmu.edu.cn/oa/DArticle.aspx?type=view&id=201211020 周红, 刘鑫, 郑江.脓毒症治疗——挑战与机遇并存[J].第三军医大学学报, 2013, 35(2): 91-94.

ZHOU H LIU X ZHENG J Sepsis treatment——Challenge and chance J Third Mil Med Univ 2013 35 2 91 94 http://aammt.tmmu.edu.cn/oa/DArticle.aspx?type=view&id=201211020 ZHOU H, LIU X, ZHENG J.Sepsis treatment——Challenge and chance[J].J Third Mil Med Univ, 2013, 35(2): 91-94.

郑江郑新川以细菌主要病原体相关分子为靶标的脓毒症防治策略第三军医大学学报 2016 38 4 323 329 10.16016/j.1000-5404.201512204 http://aammt.tmmu.edu.cn/oa/DArticle.aspx?type=view&id=201512204 郑江, 郑新川.以细菌主要病原体相关分子为靶标的脓毒症防治策略[J].第三军医大学学报, 2016, 38(4):323-329. DOI: 10.16016 /j.1000-5404.201512204.

ZHENG J ZHENG X C Targeting the major bacterial pathogen-associated molecular patterns as a strategy for the treatment of sepsis J Third Mil Med Univ 2016 38 4 323 329 10.16016/j.1000-5404.201512204 http://aammt.tmmu.edu.cn/oa/DArticle.aspx?type=view&id=201512204 ZHENG J, ZHENG X C. Targeting the major bacterial pathogen-associated molecular patterns as a strategy for the treatment of sepsis[J]. J Third Mil Med Univ, 2016, 38(4): 323-329. DOI: 10.16016 /j.1000-5404.201512204.

VAN DER POLL T VAN DEE VEERDONK F L SCICLUNA B P The immunopathology of sepsis and potential therapeutic targets Nat Rev Immunol 2017 17 7 407 420 10.1038/nri.2017.36 VAN DER POLL T, VAN DEE VEERDONK F L, SCICLUNA B P, et al . The immunopathology of sepsis and potential therapeutic targets[J ] . Nat Rev Immunol, 2017, 17(7): 407-420. DOI: 10.1038/nri.2017.36

刘伟恒关雪梅牛涧峰乌司他丁的药理作用及临床应用效果观察中国医药指南 2014 12 19 103 104 http://www.cnki.com.cn/Article/CJFDTOTAL-YYXK201419064.htm 刘伟恒, 关雪梅, 牛涧峰.乌司他丁的药理作用及临床应用效果观察[J].中国医药指南, 2014, 12(19): 103-104.

LIU W H GUAN X M NIU J F The pharmacological effect and clinical application of Ulinastatin Guide Chin Med 2014 12 19 103 104 http://www.cnki.com.cn/Article/CJFDTOTAL-YYXK201419064.htm LIU W H, GUAN X M, NIU J F. The pharmacological effect and clinical application of Ulinastatin[J]. Guide Chin Med, 2014, 12(19): 103-104.

郭宁血必净注射液的临床应用进展天津药学 2016 28 3 58 61 10.3969/j.issn.1006-5687.2016.03.021 郭宁.血必净注射液的临床应用进展[J].天津药学, 2016, 28(3): 58-61.

GUO N Clinical application of Xuebijing Injection Tianjin Pharmacy 2016 28 3 58 61 10.3969/j.issn.1006-5687.2016.03.021 GUO N. Clinical application of Xuebijing Injection[J]. Tianjin Pharmacy, 2016, 28(3): 58-61.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

线粒体预处理周细胞对脓毒症大鼠肺血管渗漏的保护作用

左旋肉碱对脓毒症心肌收缩功能障碍的改善作用及机制

PD-1介导的CD4⁺T细胞耗竭加剧脓毒症小鼠的肠道菌群异位

ATF3通过抑制ATG5和ATG16L1表达调控巨噬细胞自噬与炎症反应

瑞马唑仑对脓毒症小鼠肠道屏障功能的保护作用