Journal of Hebei Medical University ›› 2021, Vol. 42 ›› Issue (8): 920-925.doi: 10.3969/j.issn.1007-3205.2021.08.012

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Effect of ulinastatin combined with adrenal cortex hormones on intestinal mucosal barrier function, NGAL and TREM-1 levels in children with sepsis

  

  1. 1.Department of Gastroenterology, Children′s Hospital of Baoding City, Hebei Province, Baoding 
    071000, China; 2.Department of Health Care, Children′s Hospital of Baoding City, Hebei 
    Province, Baoding 071000, China; 3.Department of PICU, Children′s Hospital of 
    Baoding City, Hebei Province, Baoding 071000, China; 4.Department of 
    Neonatology, Children′s Hospital of Baoding City, Hebei Province, 
    Baoding 071000, China
  • Online:2021-08-25 Published:2021-08-27

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Abstract: Objective  To explore the effects of ulinastatin combined with adrenal cortex hormones on intestinal mucosal barrier function, neutrophil gelatinase-associated lipocalin(NGAL), and soluble myeloid cell triggered receptor-1(TREM-1) level in children with sepsis. 
Methods  A total of 82 children with sepsis admitted to our hospital were selected as research subjects, and were divided into the ulinastatin group(n=41) and the combination treatment group(n=41) according to the random number table method. The ulinastatin group was treated with ulinastatin, and the combination treatment group was treated with adrenal cortex hormones on the basis of the ulinastatin group. A blood gas analyzer was used to detect the level of lactic acid(LA), and the acute physiology and chronic health(APACHEⅡ) score was used to assess the severity of the disease. Enzyme-linked immunosorbent assay(ELISA) was used to detect heparin-binding protein(HBP), prealbumin(PA), retinol-binding protein(RBP), interleukin-6(IL-6), interleukin-10(IL-10), diamine oxidase(DAO), intestinal fatty acid binding protein(IFABP), D-lactic acid, NGAL and TREM-1 levels. An automatic biochemical analyzer was used to detect creatine kinase isoenzyme(CK-MB) and troponin I(cTnI) level. Immune function indicators were detected by flow cytometry. The LA value and therapeutic effect of the two groups of children were observed, and the LCR was calculated. 
Results  Compared with the ulinastatin group, the combination treatment group had lower LA, HBP, IL-6, CK-MB, cTnI, CD8+, DAO, IFABP, D-lactic acid, NGAL, TREM-1 levels, and APACHE Ⅱ scores(P＜0.05). Compared with the ulinastatin group, the combination treatment group had higher levels of LCR, PA, RBP, IL-10, CD3+, CD4+, NK and the total effective rate of treatment(P＜0.05). 
Conclusion  Ulinastatin combined with adrenal cortex hormones can effectively improve the clinical symptoms of children with sepsis, promote the normalization of the intestinal mucosal barrier function, and lower the levels of NGAL and TREM-1. Therefore, it is worthy of clinical popularization and application.


Key words: sepisis, ulinastatin, adrenal cortex hormones