Effect of Ulinastatin on the iron metabolism, severity and prognosis of septic patients / 中华急诊医学杂志

ABSTRACT

Objective To explore the effect of Ulinastatin on the iron metabolism,severity and prognosisof septic patients.Methods A total of 98 septic patients who met the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) were collected in the Emergency Intensive Care Unit of First Affiliated Hospital of Dalian Medical University from January 2017 to December 2017.Patients were randomly divided into the conventional treatment group (n=49) and Ulinastatin group (n=49).In addition,healthy volunteers matched for gender and age were selected as the control group (n=20).On days 1 (when enrolled for healthy volunteers),3 and 7 after admission peripheral venous blood was collected for routine blood test;the levels of plasma ferritin,erythropoietin (EPO),soluble transferrin receptor (sTFR),hepcidin and intedeukin-6 (IL-6) were measured using enzyme-linked immunosorbent assay (ELISA) and the sTFR/log ferritin index was calculated.SOFA score was assessed and the survival time was recorded within 28 days after admission.Results On days 1,3,and 7 after admission red cell distribution width and plasma EPO,sTFR,hepcidin,ferritin and IL-6 were significantly increased and hemoglobin and sTFR/log ferritin were significantly decreased in the conventional treatment group compared with those in the control group (all P＜0.05);on days 3 and 7 after admission plasma hepcidin,ferritin and IL-6 were significantly decreased and plasma EPO and sTFR/log ferritin were significantly increased in the Ulinastatin group compared with those in the conventional treatment group (all P＜0.05).On day 7 after admission SOFA score in the Ulinastatin group was significantly decreased compared with that in the conventional treatment group [(5.2±2.3) vs (6.4±2.7),P=0.019)].There was no significant difference in the 28-day survival rate (47％ vs 43％) and the survival time (18 d vs 9 d) after admission between the conventional treatment and Ulinastatin groups (both P＞0.05).Conclusions Iron metabolism disorder and inflammatory anemia occur in the early stage of septic patients.Ulinastatin might improve the iron metabolism disorder and the severity,but it cannot significantly improve anemia and prognosis of septic patients.