王鸿燕,刘树元.乌司他丁对心脏骤停后综合征患者氧化应激水平的影响[J].转化医学杂志,2019,8(3):162-165
乌司他丁对心脏骤停后综合征患者氧化应激水平的影响
Effects of ulinastatin on oxidative stress and mortality ratein patients with post-cardiac arrest syndrome
  
DOI:
中文关键词:  乌司他丁  心脏骤停后综合征  氧化应激  乳酸  中心静脉血氧饱和度
英文关键词:Ulinastatin  Post-cardiac arrest syndrome (PCAS)  Oxidative stress  Lactate  Central venous oxygen saturation (ScvO2)
基金项目:原海军总医院2018年度新技术新业务基金项目(HZXJS[2018]-12)
作者单位
王鸿燕 中国人民解放军总医院第六医学中心干部心血管内科 
刘树元 中国人民解放军总医院第六医学中心急诊科 
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中文摘要:
      目的 探讨乌司他丁对心脏骤停后综合征(post-cardiac arrest syndrome,PCAS)患者氧化应激水平的影响及其临床意义。方法 选择解放军总医院第六医学中心ICU收治的95例PCAS患者,随机分为对照组和治疗组。2组患者均给予PCAS集束化治疗,在此基础上治疗组患者静脉注射乌司他丁300 000 U/d,连用5 d;对照组静脉注射等量的生理盐水。分别在用药前和用药5 d后测定血清总超氧化物岐化酶(total superoxide dismutase,T-SOD)活力、总抗氧化力(total anti-oxidation capacity,T-目的 探讨乌司他丁对心脏骤停后综合征(post-cardiac arrest syndrome,PCAS)患者氧化应激水平的影响及其临床意义。方法 选择解放军总医院第六医学中心ICU收治的95例PCAS患者,随机分为对照组和治疗组。2组患者均给予PCAS集束化治疗,在此基础上治疗组患者静脉注射乌司他丁300 000 U/d,连用5 d;对照组静脉注射等量的生理盐水。分别在用药前和用药5 d后测定血清总超氧化物岐化酶(total superoxide dismutase,T-SOD)活力、总抗氧化力(total anti-oxidation capacity,T-AOC)、丙二醛(malondialdehyde,MDA)含量;分别于治疗第1(干预前)、2、3、4、5天测定血乳酸和中心静脉血氧饱和度(central venous oxygen saturation,ScvO2),比较2组间上述指标及2组患者28 d病死率的差异。结果 〗干预前2组患者T-SOD活力、T-AOC、MDA、血乳酸及ScvO2差异比较无统计学意义(P>0.05);用药5 d后,治疗组T-SOD活力和T-AOC显著高于对照组,MDA含量显著低于对照组(P<0.05)。2组患者第1、2、3、4、5天血乳酸和ScvO2差异比较无统计学意义(P>0.05)。2组患者28 d病死率差异比较无统计学意义(P>0.05)。结论 乌司他丁可能会减轻PCAS患者体内氧化应激水平,但对血乳酸和ScvO2无明显影响,也未能改善28 d病死率。AOC)、丙二醛(malondialdehyde,MDA)含量;分别于治疗第1(干预前)、2、3、4、5天测定血乳酸和中心静脉血氧饱和度(central venous oxygen saturation,ScvO2),比较2组间上述指标及2组患者28 d病死率的差异。结果 干预前2组患者T-SOD活力、T-AOC、MDA、血乳酸及ScvO2差异比较无统计学意义(P>0.05);用药5 d后,治疗组T-SOD活力和T-AOC显著高于对照组,MDA含量显著低于对照组(P<0.05)。2组患者第1、2、3、4、5天血乳酸和ScvO2差异比较无统计学意义(P>0.05)。2组患者28 d病死率差异比较无统计学意义(P>0.05)。结论 乌司他丁可能会减轻PCAS患者体内氧化应激水平,但对血乳酸和ScvO2无明显影响,也未能改善28 d病死率。
英文摘要:
      Objective To explore the effects of ulinastatin on oxidative stress and mortality rate in patients with post-cardiac arrest syndrome (PCAS). Methods Ninety five patients in ICU of the Sixth Medical Center of PLA General Hospital with PCAS were enrolled and randomly divided into control group and treatment group. Bundle therapeutic measures were implemented in both groups. Besides, the patients in treating group were additionally injected with ulinastatin by vein with 300 000 U/d,for five consecutive days, while the same volume of saline injection were given in control group. The oxidative stress indicators of serum malondialdehyde (MDA) contents, total superoxide dismutase (T-SOD) activities and total anti-oxidation capacity (T-AOC) were tested in two groups before intervention and five consecutive days after intervention by ulinastatin or saline. Blood lactates and central venous oxygen saturation (ScvO2) were also tested at the time of 1 (before intervention), 2, 3, 4, 5 d. Mortality after 28 days were observed in both groups. Results There were no significant difference of T-SOD activities, T-AOC, MDA contents, blood lactates and ScvO2 in both groups before intervention (P>0.05). But 5 days after ulinastatin or saline injection, T-SOD activities and T-AOC were significantly higher, and MDA contents were significantly lower in treating group than those in control group (P<0.05). However, no difference on blood lactates and ScvO2 were found between both the groups at the time of 1,2, 3 ,4, 5 d (P>0.05). There were also no difference on 28 d mortality between both groups (P>0.05). Conclusion Ulinastatin maybe protect against the damage of oxidative stress in patients with PCAS. But this study failed to observe effects on blood lactates and ScvO2, and improvement of 28 d mortality by ulinastatin in patients with PCAS.
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