Abstract: 【Abstract】Objective To investigate the effect of ulinastatin combined with continuous blood purification (CBP) in the treatment of severe sepsis and its effects on microcirculation indexes, plasma polysaccharide coating level and prognosis. Methods A total of 130 patients with severe sepsis treated in our hospital from August 2017 to January 2020 were divided into observation group (Ulinastatin+CBP, n=78) and control group (CBP, n=52). The disease improvement indexes, microcirculation indexes and plasma polysaccharide coating level before and after the treatment were compared between the two groups. The incidence of complications and 28-day mortality in the two groups were recorded to evaluate their prognosis. Results Compared with the control group, the scores of sequential organ failure assessment (t=7.835, P＜0.001), acute physiology and chronic health status II (t=8.264, P＜0.001), total sublingual vascular density (t=8.101, P＜0.001), sublingual perfusion vascular density (t=3.905, P＜0.001), plasma hyaluronic acid (t=2.216, P=0.028), plasma multi ligand proteoglycan- 1 (t=6.792, P＜0.001), plasma heparan sulfate (t=3.457, P=0.001), serum procalcitonin (t=2.994, P=0.003), serum interleukin-6 (t=9.003, P＜0.001) and serum interleukin-17 (t=6.414, P＜0.001) decreased significantly in the observation group after the treatment; the proportion of sublingual perfusion vessels (t=4.739, P＜0.001) and sublingual flow index (t=2.467, P=0.015) were higher in the observation group; the hospitalization period was shorter (t=2.219, P=0.028) and the 28-day mortality (χ2=4.670, P=0.031) was lower in the observation group. Conclusion CBP treatment combined with the administration of ulinastatin can improve the microcirculation state, alleviate the inflammatory reaction, inhibit the degradation of plasma polysaccharide, and significantly improve the short-term and long-term prognosis of the patients with severe sepsis.

Key words: Ulinastatin, Continuous blood purification, Severe sepsis, Microcirculation, Polysaccharide coating, Disease prognosis