Effect of ulinastatin on serum microribonucleic acid-23b and inflammatory factors in elderly patients with sepsis and its clinical efficacy
Received:November 12, 2018  
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DOI:10.11915/j.issn.1671-5403.2019.03.040
Key words:aged  sepsis  ulinastatin  inflammatory factor  microribonucleic acid-23b
Author NameAffiliationE-mail
LIU Feng Clinical Laboratory, liufengone11@sina.com 
LIU Wen-Li Department of Emergency,  
DU Yan Department of Internal Traditional Chinese Medicine, Zhangjiakou Hospital of Traditional Chinese Medicine, Zhangjiakou 075000, China  
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Abstract:
      Objective To investigate the effect of ulinastatin on serum levels of microribonucleic acid-23b (miR-23b) and infla-mmatory factors in elderly patients with sepsis and evaluate its clinical efficacy for sepsis. Methods A single-blind randomized controlled trial was devised on 64 sepsis patients admitted in the Emergency Department of our hospital from March 2017 to January 2018. They were randomly divided into the control group (n=32, conventional treatment) and the observation group (n=32, intravenous injection of 300 000 U ulinastatin, one time/8 h, on the basis of conventional therapy). The serum levels of inflammatory factors including tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and high sensitivity C-reactive protein (hs-CRP), and the expression of miR-23b were detected in the 2 groups before and 7 d after treatment. Acute physiology and chronic health evaluation system Ⅱ (APACHE Ⅱ), sequential organ failure estimation (SOFA) score, and multiple organ dysfunction syndrome (MODS) score were used to evaluate the patients′ health status, and the clinical efficacy were compared between the 2 groups. SPSS statistics 17.0 was used for data analysis, and Student′s t test, Chi-square test or rank sum test was employed for comparison between groups. Results The expression levels of miR-23b were (0.87±0.10) and (0.86±0.09) ng/ml, respectively, in the control group and observation group before treatment, and the levels were increased to (1.73±0.21) and (1.91±0.26) ng/ml in 7 d after treatment (P<0.05). The increase was more significant in the observation group than in the control group (t=2.112, P=0.037). Compared with before treatment,the levels of TNF-α, IL-6 and hs-CRP, and the scores of APACHE Ⅱ, SOFA and MODS in the 2 groups were obviously decreased after 7 d of treatment (P<0.05); and the decreases of the above indices were more remarkable in the observation group (P<0.05). The total effective rate was 75.0%(24/32) in the control group, and 90.6%(29/32) in the observation group, with statistical difference between them (Z=-2.375, P=0.018). Conclusion Ulinastatin effectively alleviates inflammatory responses and improves the prognosis in sepsis patients, which may be through regulating miR-23b expression, and it is worthy of clinical promotion.
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