不同剂量乌司他丁联合阿拓莫兰对感染性休克患者氧化应激、炎症反应 及预后的影响

To explore the effect of different doses of ulinastatin combined with atomolan on serum oxidative stress, inflammatory reaction and prognosis in patients with septic shock. 100 patients with septic shock who were treated in our hospital from May 2014 to June 2018 were selected. According to the random number table method, the patients were divided into the ulinastatin group (ulinastatin 200,000 U/d), the atomolam group (atomolam 1.8 g/d), the low-dose combination group (ulinastatin 200,000 U/d and atomolam 1.8 g/d), the high-dose combination group (ulinastatin 400,000 U/d and atomolam 1.8 g/d), with 25 cases in each group. The changes of oxidative stress indexes [malondialdehyde (MDA), advanced oxidation protein products (AOPP), superoxide dismutase (SOD) and total antioxidant capacity (T-AOC), glutathione peroxidase (GSH-Px)] and inflammation indexes[interleukin-6(IL-6), tumor necrosis factor-琢(TNF-琢), procalcitonin (PCT) and c-reactive protein (CRP)] of patients between the three groups before and after treatment were compared. Meanwhile, the differences in prognosis between the three groups were compared. The ICU hospitalization time, mechanical ventilation time, acute physiological and chronic health (APACHE II) scores and sequential organ failure (SOFA) scores, and the level of serum MDA, AOPP, IL-6, TNF-琢, PCT and CRP after treatment of patients in the high-dose combined group were all lower than those in the ulinastatin group, the atomolam group, and the low-dose combined group, while the low-dose combined group were lower than those in the ulinastatin group and the atomolam group (P＜ 0.05). The level of serum SOD, T-AOC, GSH-Px after treatment of patients in the high-dose combined group were all higher than those in the ulinastatin group, the atomolam group, and the low-dose combined group, while the low-dose combined group were higher than those in the ulinastatin group and the atomolam group (P＜ 0.05). The incidence of multiple organ dysfunction (MODS) and mortality in patients of the high-dose combined group and the low-dose combined group were lower than those in the ulinastatin group and the atomolam group (P＜ 0.05). Ulinastatin combined with atomolan is effective in the treatment of dyeability shock. It can effectively inhibit systemic oxidative stress and inflammatory reaction and improve the prognosis of patients, high dose ulinastatin combined with the treatment of septic shock is the best. [ABSTRACT FROM AUTHOR]