Efficacy of meropenem combined with ulinastatin in the treatment of septic shock
GUO Feng
LE Daoping
ZHANG Tianda
Abstract：Objective To explore the efficacy and safety of meropenem combined with ulinastatin in the treatment of patients with septic shock.Methods A retrospective controlled study was conducted.A total of 78 patients with septic shock treated at Ningde Hospital Affiliated to Ningde Normal University from June 2022 to June 2024 was enrolled and divided into the combination therapy group(n=40)and the monotherapy group(n=38)based on their original treatment regimens.The com-bination therapy group was treated with meropenem plus ulinastatin,while the monotherapy group was treated with meropenem alone.Sequential Organ Failure Assessment(SOFA),Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,length of intensive care unit(ICU)stay,clinical efficacy,levels of serum inflammatory factors(procalcitonin(PCT),C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)),myocardial function indicators(cardiac troponin I(cTnI),creatine kinase-MB(CK-MB),brain natriuretic peptide(BNP)),blood lactate levels and lactate clearance rate before and after treatment,as well as the incidence of adverse reactions,were compared between the two groups.Results After treatment,the SOFA and APACHE Ⅱ scores in the combination therapy group and monotherapy group decreased,and the scores in the combination therapy group((6.51±2.19)points,(12.34±4.99)points)were lower than those in the monotherapy group((8.45±2.87)points,(15.67±5.24)points)(t=3.367,2.875,both P<0.05).The length of ICU stay was shorter in the combination therapy group((7.91±2.38)days)than in the monotherapy group((9.87±3.29)days)(t=3.026,P<0.05).The total effective rate in the combination therapy group was 85.00%(34/40),higher than that in the monotherapy group(63.16%(24/38))(χ2=4.876,P<0.05).After treatment,levels of PCT,CRP,IL-6,and TNF-α decreased in both groups compared to pre-treatment levels,and the above indicators in the combination therapy group((10.18±5.53)μg/L,(38.12±8.84)mg/L,(25.33±6.17)pg/mL,and(24.18±9.42)pg/mL,respectively)were lower than those in the monotherapy group((18.96±7.55)μg/L,(62.03±7.27)mg/L,(37.41±7.28)pg/mL,and(30.29±10.74)pg/mL,respectively)(t=5.880,13.009,7.920,2.675,all P<0.05).After treatment,levels of cTnI,CK-MB,and BNP decreased in both groups compared to pre-treatment levels,and the above indicators in the combination therapy group((1.18±0.23)μg/L,(128.07±12.11)U/L,and(0.43±0.16)mg/L,respectively)were lower than those in the monotherapy group((1.56±0.25)μg/L,(162.43±17.2)U/L,and(0.71±0.28)mg/L,respectively)(t=6.976,10.208,5.385,all P<0.05).After treat-ment,the combination therapy group showed lower blood lactate levels and higher lactate clearance rates((2.52±0.41)mmol/L and(41.37±8.55)%,respectively)compared to the monotherapy group((2.91±0.58)mmol/L and(32.84±7.92)%,respectively)(t=3.443,4.565,both P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the combination therapy group and the monotherapy group(17.50%(7/40)vs 10.53%(4/38),χ2=0.782,P>0.05).Conclusion The combination of meropenem and ulinastatin demonstrates significant efficacy in treating septic shock,effectively improving organ function,shorten-ing ICU stay,lowering levels of inflammatory factors and lactate,increasing lactate clearance rate,with a high safety profile.
Keywords：septic shockmeropenemulinastatinefficacyinflammatory factors
Publication Date：2026-02-25
Online Publishing Date：2026-03-16(First online date of this platform, not the publication date of the document)
Pages：5( 192-196 )