【摘要】 目的研究围手术期应用乌司他丁（UTI）对老年患者器官功能保护方面的作用及保护机制。方法选择择期上腹部手术老年患者80例,随机分为2组,各40例。U组患者于术前1 d开始用UTI 2.0万U·kg^-1加入50 mL生理盐水中用微泵注射,qd,使用至术后第5天止,手术日开放中心静脉后立即用微量泵快速泵入UTI;C组均以50mL生理盐水代替UTI使用,其他常规治疗同U组。并选择不同时间点检测患者的血清TNF-α、IL-6及HO-1;分别检测两组术前1 d及术后1、3、5 d血清TNF-α、IL-6、IL-8,即时记录两组患者术后体温变化情况。结果应用2.0万U·kg^-1 UTI后U组在不同时间点IL-6、TNF-α的各项检验值均显著低于C组（P<0.05）;且术后12、24 h的HO-1活性显著升高,两组间对比差异有统计学意义（P<0.05）。结论 UTI具有抑制促炎因子释放作用,同时可降低患者体内促炎因子TNF-α、IL-6、IL-8的水平,促进HO-1反应性上调,发挥抗缺血-再灌注损伤能力,从而起到脏器保护作用。更多还原

【Abstract】 AIM To study the protective effect of the use of ulinastatin（UTI） on elderly patients’ organs. METHODS A total of 80 elderly patients who had abdominal surgery were randomly divided into 2 groups,with 40 patients in each group.Group U patients were injected with UTI of 20 000 U·kg^-1 by adding 50 mL normal saline with micro -injection pump the day before surgery,and once a day,for only 5 d after surgery.On surgery day,after opening central venous,UTI was immediately injected with micro pump.In group C,50 mL normal saline were used instead of UTI, and other conventional treatment was the same as group U.Serum TNF-α,IL-6 and HO-1 were respectively detected at different time points.The serum TNF-α,EL-6 and IL-8 were tested the day before the surgery,1,3 and 5 d after the surgery,respectively in 2 groups.The temperature changes in patients’ body were timely recorded after the surgery.RESULTS After the use of 20 000 U·kg^-1 UTI,the test values of IL-6 and TNF-αin group U were significandy lower than those in group C（P<0.05） at different periods.And the activity of HO-1 was significantly increased 24 h later,compared with 12 h later.The contrasts between the 2 groups were significant（P<0.05）.It showed that UTI could inhibit the release of TNF-αand IL-6,and the activity of HO-1 was significantly increased 12 h later and 24 h later.CONCLUSION UTI plays an important role in inhibiting the release of pro-inflammatory cytokines,and it can reduce the level of TNF-α,IL-6 and IL-8 in patients’ body,promote the reaction of HO-1.By exerting the function of anti-ischemia-reper- fusion injuiy,it can protect the organs.更多还原