Department of Anaesthesia and Critical Care, St. John's Medical College Hospital, Bengaluru, Karnataka 560034, India.
Department of Anaesthesia and Critical Care, St. John's Medical College Hospital, Bengaluru, Karnataka 560034, India.
J Crit Care. 2018 Jun;45:27-32. doi: 10.1016/j.jcrc.2018.01.021. Epub 2018 Jan 31.
To evaluate the clinical utility of Ulinastatin, a multifunctional serine protease inhibitor, in the management of severe acute pancreatitis.
We conducted a retrospective analysis of the archived data of adult patients diagnosed with acute pancreatitis and admitted to surgical intensive care unit with one or more end organ dysfunction. The patients were divided into two groups depending on whether they did or did not receive ulinastatin. Outcome variables namely in-hospital mortality, development of new-onset organ dysfunction, resolution of existing organ dysfunction by Day 5 and length of hospital stay were compared.
Forty-eight patients, 25 who received Ulinastatin (Ulinastatin group) and 23 who did not (Control group) were analyzed. The in-hospital mortality was significantly lower in the Ulinastatin group (16% vs 69.6%; p = 0.0003). Significantly smaller proportion of patients (24% vs 73.9%; p = 0.0005) developed new-onset organ dysfunction in the ulinastatin group by day 5. Resolution of existing organ dysfunctions by day 5 was more frequent in the ulinastatin group. Duration of hospital stay was similar in the two groups.
Ulinastatin treatment was associated with improved outcomes in patients with severe acute pancreatitis.
评估多功能丝氨酸蛋白酶抑制剂乌司他丁在重症急性胰腺炎治疗中的临床应用价值。
我们对患有急性胰腺炎并伴有一个或多个终末器官功能障碍而收入外科重症监护病房的成年患者的存档数据进行了回顾性分析。根据是否使用乌司他丁，将患者分为两组。比较住院死亡率、新发器官功能障碍的发生、第 5 天现有器官功能障碍的缓解以及住院时间等结局变量。
共分析了 48 例患者，其中 25 例使用乌司他丁（乌司他丁组），23 例未使用（对照组）。乌司他丁组的住院死亡率显著降低（16%比 69.6%；p=0.0003）。第 5 天新发器官功能障碍的患者比例，乌司他丁组明显较低（24%比 73.9%；p=0.0005）。乌司他丁组第 5 天现有器官功能障碍的缓解更为频繁。两组患者的住院时间相似。
乌司他丁治疗与重症急性胰腺炎患者的改善结局相关。
