CAJ | 학술논문

目的：评价乌司他丁在老年严重脓毒症患者的心脏保护作用。方法60例老年严重脓毒症患者随机分为治疗组与对照组，治疗组静脉滴注乌司他丁2×105 U，每日3次，对照组静脉滴注等量0.9％氯化钠注射液，疗程7 d。治疗前后检测2组患者心脏射血分数、B型钠尿肽前体（ Pro－BNP ）、肌钙蛋白Ⅰ（cTnI）、肌红蛋白（MYO）以及磷酸肌酸激酶同工酶（CK－MB）等心脏检查指标。结果治疗1周后，治疗组Pro－BNP为（516.0±105.1）pg· mL－1，优于对照组的（1956.6±207.2）pg· mL－1（P＜0.05）；治疗组肌红蛋白为（44.4±5.2） ng· mL－1，较对照组的（78.3±6.9）ng· mL－1下降更为明显（P＜0.05）。治疗后，2组心肌损伤标志物CK－MB、cTnI均有显著下降，但差异无统计学意义（ P＞0.05）。治疗后，心超提示左室射血分数均有所升高，但差异无统计学意义（ P＞0.05）。结论乌司他丁对老年危重症患者的心脏保护作用有良好的临床效果。
목적：평개오사타정재노년엄중농독증환자적심장보호작용。방법60례노년엄중농독증환자수궤분위치료조여대조조，치료조정맥적주오사타정2×105 U，매일3차，대조조정맥적주등량0.9％록화납주사액，료정7 d。치료전후검측2조환자심장사혈분수、B형납뇨태전체（ Pro－BNP ）、기개단백Ⅰ（cTnI）、기홍단백（MYO）이급린산기산격매동공매（CK－MB）등심장검사지표。결과치료1주후，치료조Pro－BNP위（516.0±105.1）pg· mL－1，우우대조조적（1956.6±207.2）pg· mL－1（P＜0.05）；치료조기홍단백위（44.4±5.2） ng· mL－1，교대조조적（78.3±6.9）ng· mL－1하강경위명현（P＜0.05）。치료후，2조심기손상표지물CK－MB、cTnI균유현저하강，단차이무통계학의의（ P＞0.05）。치료후，심초제시좌실사혈분수균유소승고，단차이무통계학의의（ P＞0.05）。결론오사타정대노년위중증환자적심장보호작용유량호적림상효과。
Objective To evaluate effect of ulinastatin in protecting the heart of the elderly patients with severe sepsis.Methods Sixty cases of elderly patients with severe sepsis in our hospital treated were randomly divided into treatment group and control group.The treatment group was given 2 ×10 5 U ulinastatin intravenous drip , 3 times a day , the control group were given equivalent 0.9% NaCl injection infusion.Period of treatment is 7 days.Detection of those groups before and after treatment of cardiac index cardiac ejection fraction ( EF) , B type natriuretic peptide recursor ( Pro BNP ) , cardiac troponin I ( CTn I ) , myoglobin ( MYO ) and creatine kinase isoenzyme ( CK -MB ).Results After 1 weeks treatment , the ProBNP level of the treatment group decreased significant-ly compared with the control group ( P<0.05 ).The treatment group my-oglobin decreased is more obvious than control group ( P<0.05 ).K-MB and cTnI of two groups both decreased significantly after treatment , but the treatment group and the control group had no statistical difference ( P>0.05 ).Echocardio-Graphy indicated left ventricular ejection frac-tion were increased after the treatment , the treatment group and the con-trol group had no statistical difference ( P>0.05 ).Conclusion The protective effects of ulinastatin on the critically ill elderly patients of heart protection has a good clinical effect.