摘要
目的探讨血液透析滤过联合血液灌流对急性中重症脂源性胰腺炎血糖及胰岛功能变化的影响。方法 58例急性中重症脂源性胰腺炎患者,根据治疗方案及病情情况不同分为对照组(35例)和治疗组(23例)。对照组给予内科治疗,治疗组在对照组的基础上给予血液透析滤过(HDF)+血液灌流(HP)治疗。分析两组患者治疗前,治疗后7 d、半年血糖、淀粉酶、糖化血红蛋白(HbA1c)、C肽、甘油三酯及总胆固醇、尿酸、胰岛素水平。结果治疗组血清淀粉酶恢复时间(3.26±0.92)d、尿淀粉酶恢复时间(7.31±1.52)d短于对照组的(6.53±1.24)、(12.42±2.15)d,差异具有统计学意义(P<0.05)。治疗前,治疗组血糖水平高于对照组,差异有统计学意义(P<0.05)。治疗后7 d、半年,两组患者血糖均较治疗前明显降低,差异具有统计学意义(P<0.05)。治疗前,两组甘油三酯及总胆固醇水平无明显区别;治疗后7 d两组甘油三酯及总胆固醇水平都有明显下降;治疗后半年,治疗组甘油三酯及总胆固醇水平较治疗后7 d略有下降,而对照组治疗后半年甘油三酯及总胆固醇水平较治疗后7 d升高。治疗后半年治疗组患者HbA1c下降比例大于对照组。治疗后半年,治疗组空腹胰岛素较治疗前升高,对照组空腹胰岛素较治疗前降低。治疗后7 d治疗组尿酸水平明显下降。结论 HDF+HP联合内科方法治疗急性中重症脂源性胰腺炎具有较高的临床价值,可以保护胰岛B细胞的功能。
Objective To discuss the effect of hemodiafiltration combined with hemoperfusion on blood glucose and islet function in the treatment of moderate-to-severe acute lipogenic pancreatitis. Methods A total of 58 patients with moderate-to-severe lipogenic pancreatitis were divided into control group(35 cases) and treatment group(23 cases) according to different treatment regimens and disease conditions. The control group received medical treatment, and the treatment group received hemodiafiltration(HDF) + hemoperfusion(HP) treatment on the basis of the control group. The blood glucose, amylase, glycosylated hemoglobin(HbA1c), C-peptide, triglyceride, total cholesterol, uric acid and insulin levels before treatment, 7 d and 6 months after treatment of the two groups were analyzed. Results The recovery time of serum amylase(3.26±0.92) d and recovery time of urine amylase(7.31±1.52) d of the treatment group were shorter than(6.53±1.24) and(12.42±2.15) d of the control group, and the difference was statistically significant(P<0.05). Before treatment, the blood glucose of the treatment group was higher than that of the control group, and the difference was statistically significant(P<0.05). 7 d and 6 months after treatment, the blood glucose of the two groups was obviously lower than those before treatment, and the difference was statistically significant(P<0.05). Before treatment, there was no significant difference in the levels of triglyceride and total cholesterol between the two groups;after 7 d of treatment, the levels of triglyceride and total cholesterol in the two groups were significantly decreased;6 months after treatment, the levels of triglyceride and total cholesterol in the treatment group were slightly lower than those 7 d after treatment, while the levels of triglyceride and total cholesterol in the control group after 6 months of treatment were higher than those before and 7 d after treatment. After 6 months of treatment, the reduction ratio of HbA1c in the treatment group was greater than that in the
作者
易庆华
王宏亮
徐娅蕾
江洪娟
徐玉善
桂莉
徐娟
YI Qing-hua;WANG Hong-liang;XU Ya-lei(Second Department of Internal Medicine,Guandu District People's Hospital,Kunming 650200,China)
出处
《中国实用医药》
2020年第29期8-12,共5页
China Practical Medicine
关键词
血液透析滤过联合血液灌流
急性中重症脂源性胰腺炎
胰岛功能
C肽
Hemodiafiltration combined with hemoperfusion
Moderate-to-severe acute lipogenic pancreatitis
Islet function
C-peptide
