摘要
目的探讨异甘草酸镁改善内镜下十二指肠乳头括约肌切开术(endoscopic sphincterotomy,EST)后十二指肠乳头溃疡的临床意义。方法以2013-01/2015-12月作者医院消化内科胆石症患者120例为研究对象,随机分为治疗组与对照组,各60例。所有患者行内镜下逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)及EST后,治疗组患者使用异甘草酸镁注射液进行治疗,对照组使用生理盐水。十二指肠镜复查观察十二指肠乳头溃疡愈合情况;酶联免疫吸附测定(enzyme-linked immuno sorbent assay,ELISA)实验检测患者血液中肿瘤坏死因子-α(tumour necrosis factor alpha,TNF-α)、白细胞介素6(interleukin-6,IL-6)与IL-8的相对表达情况。结果内镜下表现,治疗组患者十二指肠乳头溃疡情况大部分处于H期,而对照组患者十二指肠乳头溃疡情况大部分处于A期;治疗组患者血液TNF-α、IL-6及IL-8 36h、48 h的相对表达量分别为2.39±2.87、8.29±4.27、11.07±2.57与2.08±1.22、2.03±2.08、1.83±1.95,与对照组相比较,治疗组患者24h后其血液细胞因子相对表达均明显下调。结论异甘草酸镁能有效降低ERCP与EST术后患者全身炎症情况,对改善EST术后十二指肠乳头溃疡具有重要的临床意义。
Objective To investigate the clinical significance of magnesium isoglycyrrhizinate on the postoperative duodenal papilla ulcer of endoscopic sphincterotomy（EST）.Methods A total of 120 patients from authors,hospital who were diagnosed as cholelithiasis from January 2013 to December 2015 were randomly divided into the treatment group（n=60）and the control group（n=60）.Patients in the treatment group were treated with magnesium isoglycyrrhizinate injection and the patients in control group were treated with normal saline after endoscopic retrograde cholangiopancreatography（ERCP）and endoscopic sphincterotomy（EST）.Duodenal papilla ulcer were investigated by duodenoscopy.Tumour necrosis factor alpha（TNF-α）,interleukin-6（IL-6）and interleukin-8（IL-8）expression level in patients＇ blood were detected by enzyme-linked immune sorbent assay（ELISA）.Results Under the duodenoscopy,most of the duodenal papilla ulcer staging of treatment group was in＂H＂stage and control group was in＂A＂stage.The expressions of TNF-α,IL-6,IL-8 in blood of the treatment group at 36 h,48 h were 2.39±2.87,8.29±4.27,11.07±2.57 and 2.08±1.22,2.03±2.08,1.83±1.95,which were significantly down-regulated after 24 h treatment than those in the control group.ConclusionMagnesium isoglycyrrhizinate can effectively reduce the patients＇ systemic inflammatory after ERCP and EST,and can meliorate the postoperative duodenal papilla ulcer of EST.
作者
孙大勇
赵亚刚
宋鸿
朱鸿武
李立平
SUN Da-yong ZHAO Ya-gang SONG Hong ZHU Hong-wu LI Li-ping(Department of Gastroenterology, Guangzhou General Hospital of Guangzhou Command ,Guangzhou Guangdong 510010 ,China)
出处
《华南国防医学杂志》
CAS
2016年第9期585-588,共4页
Military Medical Journal of South China
