摘要
目的探讨生长抑素(Somatostatin,SS)联合丙氨酰-谷氨酰胺对重症肺炎患者肠道功能的保护作用。方法选择2019年9月~2021年2月蚌埠医学院第二附属医院重症医学科(Intensive Care Unit,ICU)收治的80例重症肺炎患者为研究对象。采用区组随机化方法分成对照组和观察组,每组均40例。所有患者均按照最新重症肺炎指南给予基础对症治疗,对照组给予丙氨酰-谷氨酰胺治疗,观察组给予SS联合丙氨酰-谷氨酰胺治疗,均持续治疗7 d。记录并比较两组入住ICU当日和治疗7d后血清降钙素原(Procalcitonin,PCT)、C-反应蛋白(C-reactive protein,CRP)、二胺氧化酶(Diamine oxidase,DAO)、D-乳酸(D-lactic acid,D-Lac)、血清细菌内毒素(Bacterial Endotoxin,BE)水平及急性生理与慢性健康评分(Acute Physiology and Chronic Health Evaluation II,APACHE II)、氧合指数(PaO 2/FiO 2);记录并比较在院期间有创呼吸机使用时间、胃肠功能障碍发生率和住院28d病死率。结果两组患者治疗7d后血清PCT、CRP和DAO、D-Lac、BE水平、APACHE II评分均较入ICU当日明显下降,差异均有统计学意义(P<0.05),且观察组上述指标均明显低于对照组(P<0.05);氧合指数则高于入ICU当日,且观察组高于对照组,差异有统计学意义。观察组呼吸机使用时间、胃肠功能障碍发生率均低于对照组,差异有统计学(P<0.05);两组28d病死率差异无统计学意义(P>0.05)。结论初步证实SS联合丙氨酰-谷氨酰治疗重症肺炎患者具有抑制炎症反应、缩短呼吸机使用时间、保护肠道功能作用。
Objective To investigate the protective effect of Somatostatin(SS)combined with alanyl glutamine on intestinal function in patients with severe pneumonia.Methods A total of 80 patients with severe pneumonia admitted to the Intensive Care Unit(ICU)of the Second Affiliated Hospital of Bengbu Medical College from September 2019 to February 2021 were selected as the research subjects.The patients or their accompanying family members gave informed consent to this study.Block randomization was used to divide them into control group and observation group,with 40 cases in each group.All patients were given basic symptomatic treatment according to the latest guidelines for severe pneumonia.Alanyl glutamine was given to the control group,and SS combined with alanyl glutamine was given to the observation group.All patients were treated for 7 days.Serum Procalcitonin(PCT),C-reactive protein(CRP),Diamine oxidase(DAO),D-lactic acid(D-LAC),serum bacterial endotoxin(BE)levels,acute physiological and chronic health scoring system(APACHEII)score,oxygenation index(PaO 2/FiO 2)were detected and compared between the two groups on ICU admission day and 7 d after treatment.The duration of invasive ventilator use,incidence of gastrointestinal dysfunction and mortality at 28 days in hospital were recorded and compared between the two groups.Results After 7 days of ICU treatment,the levels of serum PCT,CRP,DAO,D-LAC,BE,APACHE-II score in both groups were significantly decreased compared with those on the day of ICU admission(P<0.05).The above indexes in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).The oxygenation index was higher than ICU admission,the oxygenation index in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).The duration of using ICU ventilator and the incidence of gastrointestinal dysfunction in the observation group were lower than those in the control group(P<0.05),but
作者
李芳
李伯恩
许超
万雪芹
LI Fang;LI Boen;XU Chao(The Second Affiliated Hospital of Bengbu Medical College,Bengbu 233080,China)
出处
《华北理工大学学报（医学版）》
2021年第6期456-461,共6页
Journal of North China University of Science and Technology：Health Sciences Edition
基金
蚌埠医学院转化医学重点专项项目(编号:BYTM2019051)。
