摘要
目的:探讨乌司他丁联合谷氨酰胺治疗对急性重症胰腺炎患者血清淀粉酶、前白蛋白和白蛋白的影响。方法:将30例急性重症胰腺炎患者随机等比例分为常规组(n=15)与研究组(n=15),常规组予以乌司他丁治疗,研究组予以乌司他丁联合谷氨酰胺治疗,治疗14 d,比较两组临床症状改善时间(胃肠减压时间、腹痛缓解时间、首次自主排便时间、住院时间),血清相关指标(淀粉酶、前白蛋白、白蛋白)水平,炎症因子[肿瘤坏死因子-α(TNF-α)、白介素-10(IL-10)、干扰素-γ(INF-γ)]水平,免疫屏障功能[免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)]以及预后[急性生理学与慢性健康状况评分量表(APACHEⅡ)评分]与不良反应发生的变化情况。结果:治疗14 d,研究组胃肠减压、腹痛缓解、首次自主排便以及住院时间显著短于常规组(P<0.05);治疗14 d后,两组血清淀粉酶水平显著下调(P<0.05),前白蛋白、白蛋白水平显著上调(P<0.05),与常规组比较,研究组血清淀粉酶、前白蛋白、白蛋白水平更佳(P<0.05);两组TNF-α、INF-γ显著下调(P<0.05),IL-10显著上调(P<0.05),与常规组进行比较,研究组TNF-α、INF-γ、IL-10水平更佳(P<0.05);两组IgA、IgG、IgM显著上调(P<0.05),与常规组进行比较,研究组IgA、IgG、IgM水平更高(P<0.05);两组APACHEⅡ评分显著降低(P<0.05),研究组下降幅度大于常规组(P<0.05),两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:乌司他丁联合谷氨酰胺治疗急性重症胰腺炎患者可缩短临床症状改善时间,调节血清淀粉酶、前白蛋白以及白蛋白水平,抑制机体炎症反应,促进胃肠免疫功能,提高患者预后。
Objective:To explore the effect of ulinastatin combined with glutamine on serum amylase,prealbumin and albumin in patients with severe acute pancreatitis.Methods:30 patients with severe acute pancreatitis were randomly and evenly divided into conventional group(n=15)and study group(n=15).Conventional group was treated with ulinastatin,and study group was given ulinastatin combined with glutamine,and all patients were treated for 14 days.The improvement time of clinical symptoms(gastrointestinal decompression time,abdominal pain relief time,first spontaneous defecation time,hospital stay),serum related indicators(amylase,prealbumin,albumin),inflammatory factors(TNF-α,IL-10,INF-γ),immune barrier function(IgA,IgG,IgM),prognosis(APACHEⅡscore)and occurrence of adverse reactions were compared between the two groups.Results:After 14 days of treatment,the gastrointestinal decompression time,abdominal pain relief time,first spontaneous defecation time and hospital stay in study group were significantly shorter than those in conventional group(P<0.05).After 14 days of treatment,the serum amylase level in the two groups was significantly decreased(P<0.05),while the levels of prealbumin and albumin were significantly increased(P<0.05),and the levels of amylase,prealbumin and albumin in study group were better than those in conventional group(P<0.05).The TNF-αand INF-γin the two groups were significantly decreased(P<0.05),while the IL-10 was significantly increased(P<0.05),and the levels of TNF-α,IL-10 and INF-γin study group were better than those in conventional group(P<0.05).The levels of IgA,IgG and IgM were significantly increased in the two groups(P<0.05),and those of study group were better than those of conventional group(P<0.05).The APACHEⅡscore of the two groups was significantly lower(P<0.05),and the decrease range of the study group was greater than that of the conventionalal group(P<0.05).There was no significant difference in incidence rate of adverse reactions between the two groups(P>0.05).Conclusion
作者
郝昱芳
安巧和
HAO Yufang;AN Qiaohe(Department of Critical Medicine,Yulin No.2 Hospital,Shaanxi Province,Yulin 719000)
出处
《陕西医学杂志》
CAS
2020年第10期1325-1328,共4页
Shaanxi Medical Journal
基金
陕西省卫生和计划生育委员会科研项目(2015JM02034)。
