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目的:探讨乌司他丁治疗脓毒症急性肾损伤的临床效果及其可能机制。方法:选择我院2014年2月2016年8月收治的114例脓毒症急性肾损伤患者,按抽签法分为对照组(n=57)与实验组(n=57),对照组采用常规治疗,实验组基于对照组加以乌司他丁治疗,比较两组治疗前后尿液尿损伤分子-1(KIM-1)、心钠肽(ANP)、血清胱抑素-c(CYS-C)、白细胞介素1、6(IL-1、IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、一氧化氮(NO)、内皮素-1(ET-1)、免疫球蛋白A、G、M(IgA、IgG、IgM)、APACHE-Ⅱ评分。结果:治疗后,实验组尿液KIM-1、ANP、血清CYS-C、IL-1、IL-6、CRP、TNF-α、ET-1、APACHE-Ⅱ评分水平均显著低于对照组(P<0.05),血清NO、IgA、IgG、IgM水平均明显高于对照组(P<0.05)。结论:乌司他丁治疗可显著减轻脓毒症时急性肾损伤,可能与其抑制机体炎症反应,改善肾脏血流灌注,提高免疫功能有关。
Objective: To investigate the clinical effect of ulinastatin on acute renal injury induced by sepsis and its possible mechanism. Methods: A total of 114 patients with sepsis-induced acute kidney injury admitted to our hospital from February 2014 to August 2016 were divided into control group (n = 57) and experimental group (n = 57) The experimental group was treated with ulinastatin on the basis of the control group. The levels of KIM-1, ANP, CYS-C, , IL-1, IL-6, CRP, TNF-α, NO, ET-1 ), Immunoglobulin A, G, M (IgA, IgG, IgM), APACHE-II score. Results: The levels of urine KIM-1, ANP, serum CYS-C, IL-1, IL-6, CRP, TNF-α, ET-1 and APACHE-Ⅱ in the experimental group were significantly lower than those in the control group P <0.05), serum NO, IgA, IgG, IgM levels were significantly higher than the control group (P <0.05). Conclusion: Ulinastatin can significantly reduce the acute renal injury induced by sepsis, which may be related to the inhibition of inflammatory reaction, improvement of renal perfusion and enhancement of immune function.