Wang Kai, Zhu Jihong, Gao Weibo, Guo Wei, Guo Yang
Department of Emergency, Peking University People's Hospital, Beijing, 100044, People's Republic of China.
Int J Gen Med. 2024 Dec 8;17:5897-5905. doi: 10.2147/IJGM.S491193. eCollection 2024.
Severe sepsis is a systemic inflammatory response syndrome caused by infection, and the Acute Physiological Assessment and Chronic Health Evaluation II (APACHE II) scoring system is widely used to assess the severity of severe patients. Hybrid blood purification treatment (HBPT) and ulinastatin (UTI) have shown good efficacy in a variety of inflammatory diseases, and miR-146a and miR-155 were found to be closely related to inflammatory reaction. The purpose of this study was to investigate the effect of HBPT combined with UTI in the treatment of patients with severe sepsis, especially the effects on APACHE II score and miR-146a and miR-155 levels.
We carried out a retrospective analysis of clinical data with severe sepsis admitted to our hospital from January 2020 to June 2022. The patients were divided into an HBPT or HBPT+UTI group according to the treatment records. The APACHE II score, miR-146a level, miR-155 level, inflammatory factors, and rehabilitation status of both groups were analyzed and compared before and after treatment.
A total of 150 were included in the analysis, there were 77 participants in HBPT+UTI and 73 in HBPT group. After treatment, the APACHE II score and levels of miR-146a, miR-155, and inflammatory factors were significantly lower than that before treatment. Furthermore, the HBPT+UTI group showed significantly lower values than the HBPT group (all < 0.05). The recovery time of serum amylase, the disappearance time of abdominal pain, and the length of hospitalization in the HBPT+UTI group were significantly shorter than those in the HBPT group (all < 0.05).
UTI treatment combined with the administration of HBPT could improve the APACHE II score, alleviate the inflammatory reaction, and significantly improve the short-term prognosis of the patients with severe sepsis.
严重脓毒症是由感染引起的全身炎症反应综合征，急性生理与慢性健康状况评价系统II（APACHE II）评分系统广泛用于评估重症患者的严重程度。混合血液净化治疗（HBPT）和乌司他丁（UTI）在多种炎症性疾病中已显示出良好疗效，且发现miR-146a和miR-155与炎症反应密切相关。本研究旨在探讨HBPT联合UTI治疗严重脓毒症患者的效果，尤其是对APACHE II评分以及miR-146a和miR-155水平的影响。
我们对2020年1月至2022年6月在我院收治的严重脓毒症患者的临床资料进行了回顾性分析。根据治疗记录将患者分为HBPT组或HBPT+UTI组。分析比较两组治疗前后的APACHE II评分、miR-146a水平、miR-155水平、炎症因子及康复状况。
共150例纳入分析，HBPT+UTI组77例，HBPT组73例。治疗后，APACHE II评分以及miR-146a、miR-155和炎症因子水平均显著低于治疗前。此外，HBPT+UTI组的值显著低于HBPT组（均P<0.05）。HBPT+UTI组血清淀粉酶恢复时间、腹痛消失时间及住院时间均显著短于HBPT组（均P<0.05）。
UTI联合HBPT治疗可改善APACHE II评分，减轻炎症反应，并显著改善严重脓毒症患者的短期预后。
