摘要
目的探讨奥曲肽联合生长激素对重症监护病房急性胰腺炎(AP)患者炎症因子及免疫功能和血液流变学的影响。方法选择2015年1月至2017年5月武汉市黄陂区人民医院重症监护病房收治的80例AP患者,按照计算机随机法分为对照组(38例)及观察组(42例)。对照组在常规治疗基础上给予奥曲肽治疗,观察组在对照组基础上给予生长激素治疗,均连续治疗5d。比较2组治疗前后炎症因子、免疫功能和血液流变学指标。结果治疗后,观察组血清C反应蛋白、肿瘤坏死因子a、白细胞介素6和白细胞介素10水平均明显低于对照组[(87±27)mg/L比(121±26)mg/L、(115±55)ng/L比(152±50)ng/L、(114±16)ng/L比(208±15)ng/L、(69±25)ng/L比(90±22)ng/L],CD_3~+细胞、CD_4~+细胞比例和CD_4~+CD_8~+比值均明显高于对照组,CD_8~+细胞比例明显低于对照组,且全血高切黏度、血浆黏度、血栓长度、血小板黏附率明显低于对照组,差异均有统计学意义(均P<0.05)。结论奥曲肽联合生长激素治疗重症监护病房AP患者,能够有效降低炎症因子水平,改善免疫功能及血液流变学指标。
Objective To investigate the effect of octreotide combined with growth hormone on inflammatory factors,immune function and hemorheology in patients with acute pancreatitis(AP) in intensive care unit.Methods From January 2015 to May 2017, 80 AP patients were enrolled from Intensive Care Unit of Huangpi District People's Hospital of Wuhan City. The patients were randomly divided into control group(38 cases) and observation group(42 cases). The control group was treated with octreotide on the basis of routine treatment. The observation group was treated with growth hormone on the basis of control group. All patients were treated continuously for 5 clays. Inflammatory factors, immune function and hemorheological indexes were analyzed before and after treatment. Results After treatment, levels of serum C-reactive protein, tumor necrosis factor-α,interleukin-6 and interleukin-10 in the observation group were significantly lower than those in the control group [(87 ±27) mg/L vs(121±26)mg/L,(115±55)ng/L vs(152±50)ng/L,(114±16)ng/Lvs(208 ±15)ng/L,(69±25)ng/L vs(90 ±22)ng/L]; ratios of CD_3~+,CD_4~+,CD_4~+/CD_8~+ in the observation group were significantly higher and the ratio of CD_8~+ was significantly lower than those in the control group; the whole blood high shear viscosity, plasma viscosity, thrombus length and platelet adhesion rate in the observation group were significantly lower than those in the control group(P <0. 05). Conclusion Octreotide combined with growth hormone can reduce inflammatory factors, improve immune function and hemorheology in patients with acute pancreatitis.
引文
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