Clinical study on ulinastatin intervention in severe acute organophosphorus pesticide poisoning

Objective To evaluate the effects of ulinastatin on the prevention and treatment of multiple organ dysfunction syn- drome(MODS)and the decrease of the mortality.Methods 45 patients of severe acute organophosphorus pesticide poisoning(AOPP) were randomly divided into ulinastatin intervention group and non-ulinastatin intervention group.We compared the changes of whole blood acetytcholine esterase,ereatine kinase isoenzyme,arterial blood gas(ABG)and hemodynamics of the two groups before and after the treatment.The functional improvement rate of lung and extra-pulmonary organs,complication incidence of mechanical ventilation,mor- tality in ICU and the causes of death were also compared.Results There were no significant differences in the age,whole blood acetyl- choline esterase and acute physiology and chronic health evaluationⅡ(APACHEⅡ)scores of the two groups(P＞0.05);The effects of uli- nastatin intervention on whole blood acetylcholine esterase,creatine kinase isoenzyme,ABG and hemodynamics in severe AOPP patients were superior to control group;The functional improvement rates of lung and extra-pulmonary organs in ulinastatin intervention group ob- viously outstripped those in control group ,and the incidence of ventilator-associated pneumonia(VAP),myocardial ischemia and ar- rhythmia were also obviously decreased;The mortality of multiple organ failure of ulinastatin intervention group in ICU was 4.35%, which was obviously ]ower than that(27.27%)of eontrol group(P＜0.05),and the recovery rate of severe AOPP in ICU increased from 72.73% to 95.65%(P＜0.05).Conclusion Ulinastatin intervention can improve the whole blood acetylcholine esterase,creatine ki- nase isoenzyme,ABG and hemodynamics of severe AOPP patients,and decrease the incidence of VAP,myocardial ischemia and arrhyth- mia,and has great clinical effects on the prevention and treatment of MODS induced by AOPP and the decrease of the mortality.