The Clinical Evaluation On Adjuvant Therapy Of Ulinastatin Combining With Xuebijing Injection To The PR-MODS Patients

Cardiac arrest is a common critical illness. With the continuous development andpopularization of cardiopulmonary resuscitation(CPR), the rate of resumption ofspontaneous circulation(ROSC) after cardiac arrest has improved, but also there is a highmortality after successful resuscitation, which are closely related with PR-MODS(post-resuscitation multiple organ dysfunction syndrome). It is reported that the PR-MODShas become an independent factor which affects the survival after resuscitation.Therefore,how to prevent PR-MODS has now become the difficulty in the region of CPR. There isno western drug is confirmed to be effective until now. The UTI which can inhibit theactivity of various hydrolytic enzymes, stabilize lysosomal membrane, clear oxygen freeradicals (OFR), regulate the inflammatory mediator releasing, is widely used in thetreatment of acute pancreatitis, acute lung injury, Acute Respiratory DistressSyndrome(ARDS), systemic inflammatory response syndrome(SIRS), multiple organdysfunction syndrome MODS and used to protect perioperative organ injury. Xuebijinginjection is widely used in the therapy of systemic inflammatory response syndrome (SIRS)and multiple organ dysfunction syndrome(MODS) which is caused by various kinds ofcritical illnesses these years because it can suppress inflammatory response and protect thefunction of multiple organs. The intervention of Ulinastatin combining with Xuebijinginjection in the therapy of PR-MODS is lack and the outcome measures aren’t enough so itcan not reflect the influence of its function of protecting multiple organs and finalprognosis. So we discuss the effect of Ulinastatin combining with Xuebijing injection toPR-MODS by several outcome measures.Objective: We discuss the function of Ulinastatin combining with Xuebijing injectionin the therapy of PR-MODS by means of use it to patient who suffer from CA and ROSCas adjuvant therapy in order to discuss the clinical evaluation of Ulinastatin combiningwith Xuebijing injection to PR-MODS patients.Methods: We analyzed84cardiac arrest patients retrospectively who weresuccessfully resuscitated and accompanied with MODS. Both of them were givencomprehensive treatment including correct the cause, circulation support, mechanical ventilation, mild hypothermia, infection control and so on. They were divided into fourgroups, conventional therapy group, Ulinastatin therapy group, Xuebijing therapy groupand Ulinastatin combining with Xuebijing therapy group by whether they had usedUlinastatin and Xuebijing injection or not, and22patients in conventional therapygroup,20in the Xuebijing therapy group,21in the Ulinastatin therapy group,while21inthe combining therapy group. We collected total bilirubin(TBIL), creatinine (Cr), platelet(Plt), PaO2, the level of creatine kinase-MB (CK-MB), lactic acid (Lac), and Consciousstate, systolic blood pressure(SBP), melena and borborygmus of the four groups at the timeof24h,48h,72h after the restoration of spontaneous circulation (ROSC). By comparingthe score of multiple organ dysfunction syndrome of24h,48h,72h after the restoration ofspontaneous circulation (ROSC), the cerebral performance category(CPC) and the survivalrate at the time of28d after the restoration of spontaneous circulation (ROSC) to findwhether there were differences among the four groups.Results:1.The level of CK-MB was higher in the conventional therapy group thanthat in the Ulinastatin therapy group, Xuebijing therapy group at the time of24h,48h,72htime point after ROSC（P<0.05）. The level of CK-MB was higher in the conventionaltherapy group than that in the Ulinastatin combining with Xuebijing therapy group at thetime of24h,48h,72h time point after ROSC（P<0.05）, and at the time of24h,72h timepoint after ROSC, great significant differences was observed between them（P＜0.01）；2.The level of Lac was higher in the conventional therapy group than that in the Ulinastatintherapy group, Xuebijing therapy group at the time of72h time point after ROSC（P<0.05）.The level of Lac was higher in the conventional therapy group than that in the Ulinastatincombining with Xuebijing therapy group at the time of48h,72h time point after ROSC（P<0.05）；3. The scores of the severity of MODS was higher in the conventional therapygroup than that in the Ulinastatin combining with Xuebijing therapy group at the time ofevery time point after ROSC,while at the time of72h time point after ROSC, significantdifferences was observed between them（P<0.05）. At every time point after ROSC, thescore of the severity of MODS in the Ulinastatin combining with Xuebijing therapy groupis lower than that in Ulinastatin therapy group and Xuebijing therapy group with on nosignificant differences was observed between them（P>0.05）;4. Differences of CPC at thetime of28d after ROSC were not statistically significant in the four group（sP<0.05）;5.Thesurvival rates at the time of28d after ROSC among the Ulinastatin therapy group, Xuebijing therapy group and the conventional therapy group were not statisticallysignificant（P>0.05）.while the survival rate at the time of28d after ROSC between theconventional therapy group and the combining group was statistically significan（tP<0.05）.Conclusion: Using UTI combining with Xuebijing injection as adjuvant therapy toPR-MODS can improve the function of multiple organs, alleviate the heart injury obviouslyand improve tissue perfusion, reduce the mortality.