Department of Emergency and Critical Care Medicine, Changzheng Hospital, Naval Medical University, Shanghai, China.
Department of Emergency and Critical Care Medicine, Shanghai Pudong New Area People's Hospital, Shanghai, China.
Sci Prog. 2024 Jul-Sep;107(3):368504241272696. doi: 10.1177/00368504241272696.
Ulinastatin has been applied in a series of diseases associated with inflammation but its clinical effects remain somewhat elusive.
We aimed to investigate the potential effects of ulinastatin on organ failure patients admitted to the intensive care unit (ICU).
This is a single-center retrospective study on organ failure patients from 2013 to 2019. Patients were divided into two groups according to using ulinastatin or not during hospitalization. Propensity score matching was applied to reduce bias. The outcomes of interest were 28-day all-cause mortality, length of ICU stay, and mechanical ventilation duration.
Of the 841 patients who fulfilled the entry criteria, 247 received ulinastatin. A propensity-matched cohort of 608 patients was created. No significant differences in 28-day mortality between the two groups. Sequential organ failure assessment (SOFA) was identified as the independent risk factor associated with mortality. In the subgroup with SOFA ≤ 10, patients received ulinastatin experienced significantly shorter time in ICU (10.0 d [interquartile range, IQR: 7.0∼20.0] vs 15.0 d [IQR: 7.0∼25.0]; = .004) and on mechanical ventilation (222 h [IQR:114∼349] vs 251 h [IQR: 123∼499]; = .01), but the 28-day mortality revealed no obvious difference (10.5% vs 9.4%; = .74).
Ulinastatin was beneficial in treating patients in ICU with organ failure, mainly by reducing the length of ICU stay and duration of mechanical ventilation.
尿胰蛋白酶抑制剂已应用于一系列与炎症相关的疾病，但临床疗效仍不明确。
本研究旨在探讨尿胰蛋白酶抑制剂对入住重症监护病房（ICU）的器官衰竭患者的潜在疗效。
这是一项单中心回顾性研究，纳入了 2013 年至 2019 年期间入住 ICU 的器官衰竭患者。根据住院期间是否使用尿胰蛋白酶抑制剂将患者分为两组。采用倾向评分匹配法减少偏倚。主要观察终点为 28 天全因死亡率、ICU 住院时间和机械通气时间。
符合纳入标准的 841 例患者中，有 247 例接受了尿胰蛋白酶抑制剂治疗。随后创建了一个包含 608 例患者的倾向评分匹配队列。两组患者 28 天死亡率无显著差异。序贯器官衰竭评估（SOFA）评分是与死亡率相关的独立危险因素。在 SOFA≤10 的亚组中，接受尿胰蛋白酶抑制剂治疗的患者 ICU 住院时间（10.0 d [四分位距：7.0∼20.0] 比 15.0 d [四分位距：7.0∼25.0]；=0.004）和机械通气时间（222 h [四分位距：114∼349] 比 251 h [四分位距：123∼499]；=0.01）明显缩短，但 28 天死亡率无明显差异（10.5%比 9.4%；=0.74）。
尿胰蛋白酶抑制剂对治疗 ICU 中器官衰竭的患者有益，主要表现在缩短 ICU 住院时间和机械通气时间。
