CAJ | 학술논문

目的探讨蛋白酶抑制剂乌司他丁对多器官功能障碍综合征(MODS)患者体内高级氧化蛋白产物(AoPP)和C反应蛋白(CRP)的影响.方法 72例MODS随机分为乌司他丁治疗(乌司他丁组,36例)和常规治疗(对照组,36例),乌司他丁组在对照组治疗的基础上,给予乌司他丁10 030 U·kg-1·d-1静脉注射,2次/d,连用7 d.两组患者均于治疗前,治疗3 d、5 d、7 d取外周静脉血,采用分光光度法和免疫比浊法检测血清AOPP、CRP浓度,并通过软件分析两组患者急性生理与慢性健康状况(APACHE)Ⅲ评分的变化,同时记录3 d、5 d、7 d和28 d两组患者生存或死亡情况.测定36例健康志愿者(健康组,36例)AOPP和CRP浓度作为正常值对照.结果治疗前两组AOPP和CRP浓度显著高于健康对照组(P<0.05),治疗前乌司他丁组和对照组患者的AOPP和CRP浓度差异无统计学意义(P>0.05);治疗后3 d、5 d、7 d乌司他丁组和对照组血清CRP和AOPP浓度均较治疗前逐步下降(P<0.05);与对照组相比,乌司他丁组患者AOPP和CRP浓度下降更显著(P<0.05),APACHE Ⅲ评分降低更明显(P<0.05),同时28 d病死率显著降低(P<0.05).结论乌司他丁可显著降低AOPP和CRP的浓度,减轻MODS患者体内氧化应激损伤和炎性反应,从而缓解临床症状,改善疾病的预后.
목적 탐토단백매억제제오사타정대다기관공능장애종합정(MODS)환자체내고급양화단백산물(AoPP)화C반응단백(CRP)적영향.방법 72례MODS수궤분위오사타정치료(오사타정조,36례)화상규치료(대조조,36례),오사타정조재대조조치료적기출상,급여오사타정10 030 U·kg-1·d-1정맥주사,2차/d,련용7 d.량조환자균우치료전,치료3 d、5 d、7 d취외주정맥혈,채용분광광도법화면역비탁법검측혈청AOPP、CRP농도,병통과연건분석량조환자급성생리여만성건강상황(APACHE)Ⅲ평분적변화,동시기록3 d、5 d、7 d화28 d량조환자생존혹사망정황.측정36례건강지원자(건강조,36례)AOPP화CRP농도작위정상치대조.결과 치료전량조AOPP화CRP농도현저고우건강대조조(P<0.05),치료전오사타정조화대조조환자적AOPP화CRP농도차이무통계학의의(P>0.05);치료후3 d、5 d、7 d오사타정조화대조조혈청CRP화AOPP농도균교치료전축보하강(P<0.05);여대조조상비,오사타정조환자AOPP화CRP농도하강경현저(P<0.05),APACHE Ⅲ평분강저경명현(P<0.05),동시28 d병사솔현저강저(P<0.05).결론 오사타정가현저강저AOPP화CRP적농도,감경MODS환자체내양화응격손상화염성반응,종이완해림상증상,개선질병적예후.
Objective To investigate the effects of ulinastatin on serum concentrations of advanced oxidation protein products and C-reactive protein in patients with multiple organ dysfunction syndrome(MODS).Methods Seventy-two patients with MODS were randomly divided into ulinastatin group(n=36) and control group(n=36).The serum concentrations of advanced oxidation protein products and C-reactive protein in two groups were determined before therapy and after 3d,5d and 7d of therapy.Acute physiology and chronic health evaluation Ⅲ (APACHE Ⅲ)for patients were recorded before therapy and after 3d,5d,7d of therapy.Mortality within 28d was also compared between the two groups.The serum concentrations of advanced oxidation protein products and C-reactive protein in 36 healthy volunteers were detected as normal control.Results The concentrations of AOPP and CRP in patients with MODS before therapy were significantly higher than those obtained from healthy volunteers(P<0.05), whereas no obvions difference was found between the two groups.However,the levels of AOPP and CRP in patients with MODS were significantly decreased after 3d,5d,7d of therapy.Compared with control group,AOPP concentrations and CRP levels were markedly attenuated and APACHE Ⅲ scores decreased significantly in ulinastatin group(P<0.05).The mortality in ulinastatin group was also improved more significantly than that in control group(P<0.05).Conclusion Ulinastatin can decrease the concentrations of serum AOPP and CRP in patients with MODS,so as to alleviate the damage resulting from oxidative stress and inflammation,contributing to improve the outcome in patients with MODS.