摘要目的:探讨乌司他丁对脓毒症急性肾损伤(AKI)患者尿肾损伤分子-1(KIM-1)、心钠肽(ANP)、中性粒细胞胶原酶相关脂质运载蛋白(NGAL)、半胱氨酸蛋白酶抑制剂C(Cys-C)、白介素-18(IL-18)水平的影响。方法:收集2018年1月至2019年12月期间本院收治的脓毒症并发AKI患者120例，随机分为观察组与对照组(各60例)。对照组接受规范化治疗，观察组在对照组基础上加用乌司他丁。评价治疗前后急性生理与慢性健康评价量表Ⅱ(APACHEⅡ)，测定尿液KIM-1、ANP、NGAL、Cys-C和IL-18水平变化和血清白介素-2(IL-2)、白介素-10(IL-10)及肾功能指标。结果:治疗3、7、14 d后，观察组的APACHEⅡ评分均低于对照组( P<0.05)。治疗14 d后，观察组的血清肌酐(Scr)、尿素氮(BUN)、尿酸(UA)、尿液KIM-1、ANP、NGAL、Cys-C和IL-18均低于对照组( P<0.05)；观察组的24 h尿量、IL-2/IL-10比值高于对照组，但血清IL-2、IL-10水平低于对照组( P<0.05)。 结论:乌司他丁可抑制炎症反应、调节免疫功能并降低尿KIM-1、ANP、NGAL、Cys-C、IL-18的表达，对脓毒症AKI具有肾保护作用。

abstractsObjective:To investigate the influence of ulinastatin on urine renal injury molecule-1 (KIM-1), atrial natriuretic peptide (ANP), neutrophil collagenase-associated lipocalin (NGAL), cysteine protease inhibitor C (Cys-C) and interleukin-18 (IL-18) in patients with acute renal injury (AKI) induced by sepsis.Methods:From January 2018 to December 2019, 120 patients with sepsis complicated with AKI in our hospital were collected and randomly divided into observation group and control group, with 60 cases in each group. The control group received standardized treatment, the observation group received ulinastatin treatment on the basis of control group. The acute physiological and chronic health assessment scaleⅡ(APACHEⅡ) was evaluated before and after treatment, the changes of urine KIM-1, ANP, NGAL, Cys-C, and IL-18 levels and serum interleukin-2 (IL-2) and interleukin-10 (IL-10) were detected.Results:After 3, 7 and 14 days of treatment, the APACHEⅡscore of the observation group was lower than the control group ( P<0.05). After 14 days of treatment, the Scr, BUN, UA, urine levels of KIM-1, ANP, NGAL, Cys-C and IL-18 in the observation group were lower than those in the control group ( P<0.05). The 24 h urine volume, ratio of IL-2/IL-10 was higher than that of the control group, while the levels of serum IL-2 and IL-10 were lower than those of the control group ( P<0.05). Conclusions:Ulinastatin can inhibit the inflammatory response, regulate the immune function and reduce the expression of urine KIM-1, ANP, NGAL, Cys-C, IL-18, it has renal protective effect for patients with AKI induced by sepsis.