摘要
目的探讨早期应用乌司他丁联合奥曲肽和血必净对重症急性胰腺炎(SAP)患者炎性反应及免疫功能的影响。方法选取2014年1月—2017年6月收治的92例SAP患者为研究对象。根据住院单双号随机分为常规组42例和联合组50例。常规组在常规治疗基础上予以奥曲肽和血必净,联合组在常规组基础上予以乌司他丁,两组均治疗7~14 d。比较两组治疗前后炎性反应及免疫功能,观察两组临床疗效及并发症发生情况。结果治疗过程中两组肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、C反应蛋白(CRP)和血淀粉酶均呈先增后降趋势,组内比较差异均有统计学意义(P<0.05)。治疗3 d和14 d时,联合组TNF-α、IL-6、CRP和血淀粉均低于常规组(P<0.05)。治疗后,两组CD4+、CD4+/CD8+高于治疗前,CD8+低于治疗前(P<0.05);且联合组CD4+、CD4+/CD8+高于常规组,CD8+低于常规组(P<0.05)。联合组总有效率高于常规组,休克和消化道出血发生率均低于常规组(P<0.05)。结论乌司他丁联合奥曲肽和血必净可显著增强SAP患者免疫功能,抑制炎性反应,改善患者预后,联合用药效果较好。
Objective To investigate effects of Ulinastatin early application combined with Octreotide and Xuebijing on inflammatory reaction and immune function in patients with severe acute pancreatitis （SAP）. Methods A total of 92 patients with SAP admitted during January 2014 and June 2017 were randomly divided into conventional group （ n =42） and combined group （ n =50） according to hospitalized numbers. Conventional group was treated with Octreotide and Xuebijing on the basis of routine treatment, and combined group was treated with Ulinastatin on the basis of routine treatment. Both groups were treated for 7-14 days. In two groups, conditions of inflammatory reaction and immune function before and after treatment were compared, and clinical efficacy and incidence rate of complications were observed. Results In two groups, levels of tumor necrosis factor-α （TNF-α）, interleukin -6 （IL-6）, C reactive protein （CRP） and hemodiastase during treatment process were increased at early period and then decreased later, and the differences were statistically significant in each one group （ P 〈0.05）. At the 3 rd d and 14 th d after treatment, TNF-α, IL-6, CRP and hemodiastase levels in combined group were significantly lower than those in conventional group （ P 〈0.05）. After treatment, CD4＋ and CD4＋/CD8＋ levels were significantly higher, while CD8＋ levels were significantly lower than those before treatment in two groups （ P 〈0.05）; CD4＋ and CD4＋/CD8＋ levels in combined group were significantly higher, while CD8＋ level was significantly lower than those in conventional group （ P 〈0.05）. The total effective rate in combined group was significantly higher, while incidence rates of shock and gastrointestinal bleeding were significantly lower than those in conventional group （ P 〈0.05）. Conclusion Ulinastatin combined with Octreotide and Xuebijing may significantly enhance immune function, inhibit inflammatory reaction and improve prognosis of SAP patients wi
作者
张继乔
谭家武
高峰
张辉
杨谋冠
ZHANG Ji-qiao;TAN Jia-wu;GAO Feng;ZHANG Hui;YANG Mou-guan(Department of Gastroenterology,Minda Hospital Affiliated to Hubei Nationality College,Enshi,Hubei 445000,China)
出处
《解放军医药杂志》
CAS
2018年第9期93-96,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
湖北省教育厅重点项目(Q30241002)
关键词
乌司他丁
重症急性胰腺炎
炎症
免疫
Ulinastatin
Severe acute pancreatitis
Inflammation
Immunity
