Apizi Anwaier, Li Jian, Liu Wei, Dong Liangjie, Ding Yunfei, Yu Zhaoxia
Department of Critical Care Medicine, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang, China.
Department of Critical Care Medicine, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang, China.
Toxicol Appl Pharmacol. 2025 Jun;499:117312. doi: 10.1016/j.taap.2025.117312. Epub 2025 Mar 25.
This study aims to investigate the effects of continuous renal replacement therapy (CRRT) combined with ulinastatin on cytokine levels and prognosis in patients with sepsis. The control and study groups (40 cases each) were established. The control group received CRRT alone, while the study group received CRRT plus ulinastatin treatment, with both groups being treated for 7 days. We compared the following parameters before and after treatment between the two groups: Sequential Organ Failure Assessment (SOFA) scores, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, renal function indicators [cystatin C (CysC), blood urea nitrogen (BUN), and serum creatinine (SCr)], inflammatory factors [tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and procalcitonin (PCT)], and immune function parameters (CD4+, CD8+, CD4+/CD8+ ratio). Additionally, we recorded adverse reactions and 28-day mortality rates in both groups. After 7 days of treatment, the study group showed significantly lower SOFA scores, APACHE II scores, serum levels of CysC, BUN, Scr, TNF-α, CRP, PCT, and peripheral blood CD8+ compared to the control group, while demonstrating higher peripheral blood CD4+ and CD4+/CD8+ ratio. During the treatment period, there was no significant difference in the incidence of adverse reactions between the two groups. However, the 28-day mortality rate was significantly lower in the study group compared to the control group. For patients with sepsis, the combination of CRRT and ulinastatin therapy can significantly improve disease severity, inflammatory factors, renal function, and immune function, while reducing mortality rate.
本研究旨在探讨连续性肾脏替代疗法（CRRT）联合乌司他丁对脓毒症患者细胞因子水平及预后的影响。设立对照组和研究组（每组40例）。对照组仅接受CRRT治疗，而研究组接受CRRT联合乌司他丁治疗，两组均治疗7天。我们比较了两组治疗前后的以下参数：序贯器官衰竭评估（SOFA）评分、急性生理与慢性健康状况评分系统II（APACHE II）评分、肾功能指标[胱抑素C（CysC）、血尿素氮（BUN）和血清肌酐（SCr）]、炎症因子[肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）和降钙素原（PCT）]以及免疫功能参数（CD4+、CD8+、CD4+/CD8+比值）。此外，我们记录了两组的不良反应和28天死亡率。治疗7天后，研究组的SOFA评分、APACHE II评分、CysC、BUN、Scr、TNF-α、CRP、PCT血清水平及外周血CD8+水平均显著低于对照组，而外周血CD4+及CD4+/CD8+比值则高于对照组。治疗期间，两组不良反应发生率无显著差异。然而，研究组的28天死亡率显著低于对照组。对于脓毒症患者，CRRT与乌司他丁联合治疗可显著改善疾病严重程度、炎症因子、肾功能及免疫功能，同时降低死亡率。
