乌司他丁对感染所致急性循环衰竭患者微循环的影响

UTI Influence on Microcirculation in Patients with Acute Circulatory Failure Caused by Infection

摘要: 目的：探究乌司他丁能否通过改善感染所致急性循环衰竭患者的微循环灌注从而改善其预后。方法：1)收集2018~5至2019~12入住青岛大学附属医院综合ICU及急诊ICU感染所致急性微循环衰竭患者共50例，随机将其分为对照组25例(仅接受常规治疗)和实验组25例(乌司他丁 + 常规治疗)。2) 分别用LH-SDF-1型SDF观测仪(徐州利华电子科技发展有限公司)观察对照组和实验组患者0 h、3 h、6 h、12 h、24 h、48 h、72 h的舌下微循环状态，分别计算出相应微血管流动指数(MFI)、总血管密度(TVD)、灌注血管密度(PVD)、灌注血管比例(PPV)。3) 分别统计出两组患者的各自的72小时ΔSOFA、30天全因病死率。4) 所获得的数据采用SPSS22软件针对各组定量数据进行独立样本t检验，率的比较采用χ2检验，P < 0.05视为有统计学差异。结果：1) 乌司他丁组的用药48小时后微循环指标明显高于常规对照组(P均 < 0.05，详见正文)。2) 乌司他丁组的72小时ΔSOFA要明显高于常规对照组(P = 0.005, t = 2.980)；乌司他丁组中30天死亡率为8%，常规对照组中30天死亡率为24%。结论：与常规对照组治疗相比，加用乌司他丁能够改善感染所致急性循环衰竭患者用药后48小时的所有微血管指标，能够明显地改善72小时SOFA评分，从而改善30天预后。

Abstract: Objective: To explore whether Ulinastatin (UTI) can improve microcirculation in patients with acute circulatory failure caused by infection to improve their prognosis. Methods: 1) Collect 50 patients with acute circulatory failure caused by infection which were admitted to intensive care unit in Affiliated Hospital of Qingdao University during 2018-5 to 2019-12. They were randomly divided into 25 control group and 25 UTI group. The control group received conventional treatment, and the UTI group was on the basis of conventional therapy plus UTI. 2) Use LH-SDF-1 type SDF observer (Xuzhou Lihua Electronic Technology Development Co., Ltd.) to observe control group and UTI group patients’ sublingual microcirculation at the time point of 0 h, 3 h, 6 h, 12 h, 24 h, 48 h, 72 h, then calculate microvascular flow index (MFI), total vessel density (TVD), perfused vessel density (PVD), proportion of perfused vessels (PPV). 3) The 72 hours of ΔSequential Organ Failure Assessment (ΔSOFA) and 30 days of all-cause mortality in the two groups were calculated. 4) Independent samples t-test was performed for each group of quantitative data by the software of SPSS 22nd edition. χ2 test was used to compare rates for each group. P < 0.05 was considered statistically significant. Results: 1) The results show that 48 hours microcirculatory situation in the UTI group is higher than the control group (P < 0.05, see in the next). 2) The 72 hours ΔSOFA in the UTI group is higher than the control group (P = 0.005, t = 2.980). The 30-day mortality rate in the UTI group is 8% and in the control group is 24%. Conclusion: Compared with the conventional control group, plus UTI can improve all microcirculation indicators after dosing for 48 hours. It can also improve 72 hours SOFA scores obviously thereby improving the prognosis of 30 days.