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目的观察蛋白酶抑制剂乌司他丁对食管癌手术应激反应的的影响。方法选择我院食管癌根治术患者60例,分为治疗组、对照组,每组30例。两组均给予常规营养支持,治疗组再加乌司他丁静脉滴注,对照组用相应生理盐水静脉滴注。手术前,术后1、3、7d分别抽取患者空腹外周静脉血,进行丙二醛(MDA)、血清超氧化物歧化酶(SOD)、血浆内毒素(ETX)、肿瘤坏死因子α(TNF-α)和IL-6测定。结果术后3d治疗组MDA、ETX低于对照组(P<0.05),术后3、7d治疗组SOD高于对照组(P<0.05)。两组患者术后TNF-α及IL-6有上升趋势,但治疗组上升较缓和。术后3d治疗组TNF-α低于对照组(P<0.05),术后7d治疗组IL-6低于对照组(P<0.05)。结论乌司他丁可减少手术氧自由基的释放、抑制过度炎症反应,保护食管、胃肠黏膜的愈合和再生,减少术后并发症的发生。
Objective To investigate the effect of ulinastatin, a protease inhibitor, on the surgical response to esophageal cancer. Methods 60 cases of esophageal cancer radical operation in our hospital were divided into treatment group and control group, 30 cases in each group. Both groups were given routine nutritional support, the treatment group plus ulinastatin intravenously, the control group with the corresponding saline intravenous drip. Fasting peripheral venous blood samples were collected before surgery and at 1, 3 and 7 days after operation for malondialdehyde (MDA), serum superoxide dismutase (SOD), plasma endotoxin (ETX) and tumor necrosis factor alpha (TNF- α) and IL-6. Results The levels of MDA and ETX in the treatment group after 3 days were lower than those in the control group (P <0.05), and the levels of SOD in the treatment group 3 and 7 days after the operation were higher than those in the control group (P <0.05). The levels of TNF-α and IL-6 in both groups increased after operation, but the treatment group increased more slowly. The level of TNF-α in the three days after operation was lower than that in the control group (P <0.05), and the level of IL-6 in the seventh day after operation was lower than that of the control group (P <0.05). Conclusion Ulinastatin can reduce the release of oxygen free radicals, inhibit the excessive inflammatory reaction, protect the esophagus and gastrointestinal mucosa from healing and regeneration, and reduce the incidence of postoperative complications.