目的 探討烏司他丁治療膿毒血癥的臨床效果及安全性。方法 選取牡丹江醫(yī)學(xué)院第二附屬醫(yī)院2012年1月至2013年1月收治的膿毒血癥患者40例，隨機(jī)分為治療組（20例）及對照組（20例），對照組采用傳統(tǒng)抗感染、對癥支持、穩(wěn)定內(nèi)環(huán)境治療，治療組在對照組治療基礎(chǔ)上加用烏司他丁3×105 U＋5%葡萄糖100 mL，靜脈滴注，0.8 h/次，3 次/d，兩組患者均持續(xù)治療7 d。兩組患者分別于治療前后采用APACHEⅡ評分表對患者病情進(jìn)行評分，同時(shí)觀察兩組患者IL-1、IL-6、IL-8、TNF-α炎癥因子水平的變化、兩組患者的預(yù)后及不良反應(yīng)發(fā)生情況。結(jié)果 治療后兩組患者APACHEⅡ評分均顯著低于治療前，且治療組患者APACHEⅡ評分較對照組低，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療組患者治療后IL-1、IL-6、IL-8、TNF-α水平均顯著低于對照組，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療后治療組患者白細(xì)胞計(jì)數(shù)、中性粒細(xì)胞計(jì)數(shù)、體溫顯著低于對照組，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05），而心率與對照組相比無統(tǒng)計(jì)學(xué)意義。對照組患者無發(fā)生不良反應(yīng)，治療組患者嘔吐1例、腹瀉1例，停藥治療后癥狀自行消失，兩組不良反應(yīng)發(fā)生率無統(tǒng)計(jì)學(xué)意義。結(jié)論 烏司他丁治療膿毒血癥患者能顯著改善其病情，降低相關(guān)炎癥因子水平，有利于患者預(yù)后。

Objective To investigate the clinical efficiency and security of ulinastatin in treatment of sepsis. Methods The patients (40 cases) diagnosed with sepsis in Second Affiliated Hospital of Mudanjiang Medical College from January 2012 to January 2013 were randomly divided into treatment (20 cases) and control (20 cases) groups. The patients in the control group were administered with traditional anti-infection, symptomatic, and supportive, stable internal environment treatment. The patients in the treatment group were iv administered with ulinastatin 3×105 U + 100 mL 5% glucose, 0.8 h/d, three times one day, and two groups were treated for 7 d. The clinical effects of patients were evaluated by APACHE II score before and after the treatment, while IL-1, IL-6, IL-8, TNF-α, and adverse reactions were observed. Results After the treatment, APACHE II scores of the two groups were significantly lower than those before the treatment, and the APACHE II score of the patients in the treatment group was lower than that in the control group with significant difference (P < 0.05). IL-1, IL-6, IL-8, and TNF-α levels of the treatment group were lower than those in the control group with significant difference (P < 0.05) after the treatment. After the treatment, white blood cell count, neutrophil count, and body temperature of patients in the treatment group were significantly lower than those of the control group with significant difference (P < 0.05), while heart rate had no statistical significance between the two groups. Patients in the control group had no adverse reactions, patients in the treatment group had one case with vomiting and one case with diarrhea, after the treatment the discontinuation symptoms disappeared, the rate of adverse reactions between the two groups had no statistical significance. Conclusion Ulinastatin in the treatment of sepsis could significantly improve the patients’ condition, and reduce the level of inflammatory factors, which are beneficial to the prognosis of the patients.