不同剂量乌司他丁对老年脓毒症患者肠黏膜屏障功能保护作用的评价

发布时间：2018-03-13 02:23

  本文选题：脓毒症　切入点：肠黏膜屏障功能　出处：《广东医学》2016年06期 　论文类型：期刊论文

【摘要】：目的探讨不同剂量乌司他丁对老年脓毒症患者肠黏膜屏障功能保护作用的影响,为临床应用提供依据。方法将入选的老年脓毒症患者随机分为小剂量治疗组(n=39)和大剂量治疗组(n=39)。小剂量治疗组给予10万U静脉注射每8 h 1次,大剂量治疗组给予20万U静脉注射每8 h 1次。分别于入住ICU当时(D0)与入住ICU后第2、3、7天(D2、D3、D7)测定血清肠脂肪酸结合蛋白(IFABP)、二胺氧化酶(DAO)、D-乳酸(DLac)水平变化,并记录患者APACHEⅡ评分、ICU住院时间及28 d生存情况。结果 (1)入科时两组患者APACHEⅡ评分、血浆IFABP、DAO、D-Lac水平差异均无统计学意义(P0.05)。(2)经治疗后,两组患者血浆IFABP、DAO、D-Lac水平均有所下降,但大剂量治疗组下降趋势表现得更加明显。从D3观察点开始,大剂量治疗组血浆IFABP、DAO、D-Lac水平均明显低于小剂量治疗组(P0.05)。(3)经治疗后,大剂量治疗组APACHEⅡ评分及ICU住院时间均低于小剂量治疗组(P0.05)。(4)两组患者28 d死亡率差异无统计学意义(P0.05)。结论大剂量乌司他丁对老年脓毒症患者肠屏障功能的保护作用更加明显,能明显改善老年脓毒症患者的预后,减少ICU住院时间,但对降低28 d死亡率无明显作用。
[Abstract]:Objective to investigate the effects of different doses of ulinastatin on intestinal mucosal barrier function in elderly patients with sepsis. Methods the geriatric sepsis patients were randomly divided into small dose treatment group and high dose treatment group. The low dose treatment group was given 100,000 U intravenously every 8 h, and the low dose treatment group was given 100,000 U intravenously once every 8 hours. 200,000 U was injected intravenously every 8 hours in the high-dose treatment group. The levels of serum fatty acid binding protein (ICU) and diamine oxidase (DAOX) were measured at the time of admission to ICU (D0) and the second day after admission to ICU (D7). The duration of hospitalization and the survival of 28 days were recorded. Results 1) there was no significant difference in APACHE 鈪，

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