摘要
目的探讨高剂量乌司他丁辅助两路早期补液对急性胰腺炎(SAP)患者早期康复及细胞免疫功能的影响。方法选取我院2019年12月至2022年3月SAP住院患者72例,随机数字表法分为研究组36例与对照组36例。入院后给予2组常规干预,在此基础上对照组采取两路早期补液,研究组于对照组基础上采取高剂量乌司他丁,均治疗14 d。统计2组症状缓解情况、临床疗效、治疗前及治疗14 d后细胞免疫功能、炎性指标[白细胞计数(WBC)、降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素(IL)-6、IL-8、肿瘤坏死因子-α(TNF-α)水平、病情严重程度评分急性生理与慢性健康评分(APACHEⅡ)]、靶器官损伤及治疗情况。结果(1)症状缓解情况:研究组呕吐恶心、腹痛、腹胀缓解用时、首次排便时间、体温恢复时间短于对照组(P<0.05);(2)临床疗效:研究组总有效率(86%)高于对照组(64%)(P<0.05)。(3)细胞免疫功能:治疗前2组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)间差异无统计学意义(P>0.05),治疗14 d后观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)较治疗前增高(P<0.05),且研究组高于对照组(P<0.05)。(4)炎性因子:治疗前2组WBC、血清PCT、CRP、IL-6、IL-8、TNF-α水平间差异无统计学意义(P>0.05),治疗14 d后2组血清IL-6、IL-8、TNF-α水平较治疗前降低(P<0.05),且研究组低于对照组(P<0.05);(5)APACHEⅡ评分:治疗前2组APACHEⅡ评分间差异无统计学意义(P>0.05),治疗14d后2组APACHEⅡ评分较治疗前降低(P<0.05),且研究组低于对照组(P<0.05)。(6)靶器官损伤及治疗情况:研究组患者靶器官损伤率低于对照组,差异有统计学意义(P<0.05);对照组1例并发MODS患者救治无效死亡,2组其余并发靶器官损伤患者均经对症支持治疗后好转。结论采取高剂量乌司他丁辅助两路早期补液治疗SAP,可有效缓解患者临床症状,减轻病情严重程度及炎性反应程度,并改善患者机体细胞免疫功能状态,提升疾病�
Objective To explore the effect of high-dose ulinastatin-assisted two routes of early fluid infusion on early rehabilitation and cellular immune function of patients with acute pancreatitis(SAP).Methods Seventy-two patients with SAP in our hospital from December 2019 to March 2022 were randomly divided into study group(n=36)and control group(n=36).After admission,routine interventions were given to the two groups.On this basis,the control group was given two routes of early fluid infusion.The study group was given high-dose ulinastatin on the basis of the control group,all of which were treated for 14 days.The remission of symptoms,clinical efficacy,cell immune function,levels of inflammatory factors,including white blood cells(WBC),procalcitonin(PCT),C-reactive protein(CRP),tumor necrosis factor(TNF)-α,interleukin(IL)-6 and IL-8 and severity score of disease(APACHE II)before and 14 days after treatment and target organ injury and treatment were analyzed.Results(1)Symptom relief:the time of vomiting,nausea,abdominal pain,abdominal distension relief,first defecation time and body temperature recovery in the study group were shorter than those in the control group(P<0.05).(2)Clinical efficacy:The total effective rate of the study group(86%)was higher than that of the control group(64%)(P<0.05).(3)Cell immune function:there was no significant difference in CD3^(+),CD4^(+),CD4^(+)/CD8^(+)between two groups before treatment(P>0.05).After 14 days treatment,CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in the two groups increased compared with before treatment(P<0.05),and those in the study group were higher than those in the control group(P<0.05).(4)Inflammatory factors:there was no significant differences in serum WBC,PCT,CRP,IL-6,IL-8 and TNF-αlevels between the two groups before treatment(P>0.05).After 14 days of treatment,the levels of WBC,PCT,CRP,IL-6,IL-8 and TNF-αin the two groups were lower than those before treatment(P<0.05),and those in the study group were lower than those in the control group(P<0.05).(5)APACHEⅡscore:
作者
王晓娟
朱季军
Wang Xiaojuan;Zhu Jijun(Department of Suqian First People′s Hospital,Jiangsu 223800,China)
出处
《山西医药杂志》
CAS
2022年第23期2653-2657,共5页
Shanxi Medical Journal
关键词
乌司他丁
早期补液
胰腺炎
急性
免疫功能
Ulinastatin
Early rehydration
Pancreatitis
acute
Immune function
