目的:探讨乌司他丁(UTI)心肌保护作用影响因素及其预防方法.方法:选取感染性休克并心功能不全、扩张型心肌病(DCM)心功能不全各30例,在常规纠正心衰基础上,分别给予小剂量、中等剂量、大剂量UTI连续应用1周、2周,治疗后1周、2周分别行心脏超声检查,测定左室收缩舒张末期内径( LVESD、LVEDD)、左室射血分数(LVEF)、左室短轴缩短率(FS),经血浆脑型利钠肽(BNP)水平,经黄嘌呤氧化酶法测定血浆超氧化物歧化酶(SOD)水平,测定心肌局部组织羟脯氨酸含量水平.结果:与其余三组相比,各组大剂量亚组心功能提高、左室内径下降、心肌局部组织Hyp含量最低,血浆SOD水平最低.结论:不同病因心肌损伤、剂量、使用时间等均会影响UTI临床疗效.%Objective:To explore influencing factors and preventive measures of the Ulinastatin(UTI) on myocardial protection. Methods:30 cases each of septic shock with cardiac insufficiency and with dilated cardiomyopathy(DCM) were chosen. UTI of small dose,media ndose and mega dose with one week and two weeks was given on the base of normal heart failure treatment. After one week and two weeks of treatment, the patients were received echocardiogram examination, Left ventricular end-diastolic contraction inner diameter(LVESD) testing, left ventricular ejection fraction(LVEF) testing, left ventricular fraction shortening(LVFS) testing, brain natriuretic peptide (BNP) level testing with plasma, superoxide dismutase(SOD) level testing with xanthine oxidase(XOD) and local tissue of myocardium hydroxyproline level testing. Results: Compared with the other three groups, high-dose UTI in each group caused an increase of cardiac function and LVD decreasing, and the lowest level of Hyp in local tissue of myocardium and plasma SOD level. Conclusions: The different causes of myocardial injury, dose, time, etc will affect the use of clinical UTI.
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