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目的:观察乌司他丁对术后老年危重患者超敏C反应蛋白(hS-CRP)水平及预后的影响,探讨其改善术后老年患者全身炎性反应综合征的作用。方法:选择符合入选标准的术后老年危重患者共95例,随机分为乌司他丁治疗组(U组)48例和对照组(C组)47例。U组患者在接受常规治疗的同时术后6 h内开始静脉注射乌司他丁,每次30万单位,q6 h,连续7 d。C组患者接受常规治疗+安慰剂(生理盐水)。2组患者分别于治疗前及治疗后第3,7天做hS-CRP检测,并同时进行APA-CHEII评分,观察并发症发生率及死亡率。结果:2组患者治疗后血清hs-CRP浓度、APACHEⅡ评分分别与治疗前比较,均明显下降,差异有统计学意义(P<0.05);U组治疗3 d后血清hs-CRP浓度、APACHEⅡ评分与C组治疗3 d后比较下降更加显著(P<0.05),并发症发生率无差异;治疗7 d后U组血清hs-CRP浓度、APACHEⅡ评分与C组比较,U组改善优于C组(P<0.01),2组并发症发生率及死亡率比较,U组明显低于C组(P<0.05)。结论:乌司他丁可抑制外科术后老年危重患者hS-CRP表达、降低患者APACHEⅡ评分,从而改善患者预后。
Objective: To observe the effect of ulinastatin on the level of hs-CRP and the prognosis of postoperative elderly critically ill patients, and to explore its effect on the improvement of systemic inflammatory response syndrome in elderly patients. Methods: A total of 95 elderly critically ill patients who met the inclusion criteria were randomly divided into ulinastatin group (48 cases) and control group (group C): 47 cases. Patients in group U received intravenous injection of ulinastatin at a dose of 300,000 units for 6 hours after operation for 6 days, continuing for 7 days. Patients in group C received routine therapy plus placebo (saline). Two groups of patients were treated with hS-CRP before treatment and at 3 and 7 days after treatment, and APA-CHEII score was also observed to observe the incidence of complications and mortality. Results: After treatment, serum hs-CRP concentration and APACHEⅡscores in two groups were significantly decreased compared with those before treatment (P <0.05). Serum levels of hs-CRP, APACHEⅡscores Compared with C group, the decrease of group C was more significant (P <0.05) and the incidence of complication was no difference. Serum hs-CRP concentration and APACHEⅡ score of U group were better than C group (P <0.01). Complication rate and mortality in two groups were significantly lower than those in group C (P <0.05). Conclusion: Ulinastatin can inhibit the expression of hS-CRP in elderly critically ill patients and reduce APACHEⅡscore in patients with post-surgery, thus improving the prognosis of patients.