Department of Emergency Medicine, Jeju National University Hospital, Jeju, Korea.
J Korean Med Sci. 2010 Jan;25(1):128-34. doi: 10.3346/jkms.2010.25.1.128. Epub 2009 Dec 26.
We investigated the use of ulinastatin in association with the suppression of polymorphonuclear leukocyte elastase (PMNE), tumor necrosis factor alpha (TNF-alpha) and interleukin 6 (IL-6), and its effects on the prognosis of patients with traumatic hemorrhagic shock. Nineteen patients who visited the emergency department for traumatic hemorrhagic shock were enrolled. Eleven patients were randomly selected to receive a total of 300,000 IU of ulinastatin. Measurements of serum PMNE, TNF-alpha and IL-6 were taken before ulinastatin treatment at 24 hr, two days, three days, and seven days after admission. We compared the Systemic Inflammatory Response Syndrome scores, Multiple Organ Dysfunction Syndrome scores and Acute Physiology, age, Chronic Health Evaluation III scores of the control and ulinastatin groups. There were no significant differences in baseline values, laboratory data, treatment or mortality between the two groups. The serum PMNE levels in the ulinastatin group were lower than in the control group on the second hospitalized day. Serum TNF-alpha and IL-6 levels in the ulinastatin group decreased 24 hr after admission but had no significance. It is suggested that ulinastatin treatment could decrease the serum PMNE levels in trauma patients with hemorrhagic shock at 48 hr after treatment.
我们研究了联合使用尿胰蛋白酶抑制剂（ulinastatin）抑制多形核白细胞弹性蛋白酶（PMNE）、肿瘤坏死因子-α（TNF-α）和白细胞介素 6（IL-6）及其对创伤性失血性休克患者预后的影响。纳入了 19 名因创伤性失血性休克就诊的患者。随机选择 11 名患者接受总共 30 万单位的尿胰蛋白酶抑制剂。在入院后 24 小时、2 天、3 天和 7 天接受 ulinastatin 治疗前，测量血清 PMNE、TNF-α 和 IL-6。我们比较了对照组和 ulinastatin 组的全身炎症反应综合征评分、多器官功能障碍综合征评分和急性生理学、年龄、慢性健康评估 III 评分。两组在基线值、实验室数据、治疗或死亡率方面无显著差异。ulinastatin 组的血清 PMNE 水平在入院第二天低于对照组。ulinastatin 组的血清 TNF-α 和 IL-6 水平在入院后 24 小时下降，但无统计学意义。提示 ulinastatin 治疗可降低创伤性失血性休克患者治疗后 48 小时的血清 PMNE 水平。
