乌司他丁联合奥曲肽对急性胰腺炎患者炎症反应及淀粉酶水平的影响
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摘要
目的:观察乌司他丁联合奥曲肽对急性胰腺炎患者炎症反应及淀粉酶水平的影响。方法:68例急性胰腺炎患者根据数字表法随机分为两组,两组患者入院后采用常规措施进行治疗,对照组(34例)在常规措施上加用奥曲肽治疗,观察组(34例)在对照组基础上加用乌司他丁治疗,两组患者均治疗7 d。比较两组患者治疗总有效率、临床症状消失时间及住院治疗时间,检测两组患者治疗前后血清肿瘤坏死因子(TNF)-α、白介素(IL)-2、C反应蛋白(CRP)等炎症反应相关指标,以及血、尿淀粉酶表达水平。结果:观察组患者治疗总有效率(91.18%)明显高于对照组(73.53%),差异有统计学意义(P<0.05);观察组患者腹痛不适、恶心呕吐、腹胀、腹膜刺激征等临床症状消失时间及住院治疗时间较对照组明显短(P<0.05);两组患者治疗前血清TNF-α、IL-2、CRP等炎症反应相关指标及血尿淀粉酶水平比较差异无统计学意义(P>0.05),治疗后两组患者炎症反应相关指标及血尿淀粉酶水平均明显降低(P<0.05),且观察组治疗后降低较对照组治疗后更为明显(P<0.05)。结论:乌司他丁联合奥曲肽治疗急性胰腺炎患者效果显著,不但可促进临床症状尽快改善,缩短住院治疗时间,还可缓解机体炎症反应,降低血尿淀粉酶水平。
Objective:To observe the effect of Ulinastatin combined with Octreotide on inflammatory response and amylase levels of patients with acute pancreatitis.Method:68 patients with acute pancreatitis were randomly divided into two groups according to the number table method.The two groups were treated with conventional measures after admission.The control group(34 cases) was treated with Octreotide on the basis of the conventional measures,and the observation group(34 cases) was treated with Ulinastatin on the basis of the control group.The total effective rate,clinical symptom disappearance time and hospitalization time of the two groups were compared,and the levels of serum tumor necrosis factor(TNF)-α,interleukin-2,C-reactive protein(CRP) and blood,urine amylase expression levels before and after treatment of the two groups were detected.Result:The total treatment effective rate of the observation group(91.18%) was significantly higher than that of the control group(73.53%),the difference was significant(P<0.05).The clinical symptoms such as abdominal pain and discomfort,nausea and vomiting,abdominal distension,peritoneal irritation and hospitalization time of the observation group were significantly shorter than those of the control group(P<0.05).There was no significant difference between the two groups before treatment about the serum TNF-α,IL-2,CRP and blood,urine amylase expression levels(P>0.05).After treatment,the inflammatory reaction related indicators and blood,urine amylase expression levels of the two groups significantly decreased(P<0.05),and the observation group decreased more significant after treatment than those of the control group after treatment(P<0.05).Conclusion:The treatment of Ulinastatin combined with Octreotide for patients with acute pancreatitis has a significant therapeutic effect,which can not only promote the clinical symptoms to improve as soon as possible,shorten the hospitalization time,but also alleviate the inflammatory reaction and reduce blood,urine amylase expression levels.
Objective:To observe the effect of Ulinastatin combined with Octreotide on inflammatory response and amylase levels of patients with acute pancreatitis.Method:68 patients with acute pancreatitis were randomly divided into two groups according to the number table method.The two groups were treated with conventional measures after admission.The control group(34 cases) was treated with Octreotide on the basis of the conventional measures,and the observation group(34 cases) was treated with Ulinastatin on the basis of the control group.The total effective rate,clinical symptom disappearance time and hospitalization time of the two groups were compared,and the levels of serum tumor necrosis factor(TNF)-α,interleukin-2,C-reactive protein(CRP) and blood,urine amylase expression levels before and after treatment of the two groups were detected.Result:The total treatment effective rate of the observation group(91.18%) was significantly higher than that of the control group(73.53%),the difference was significant(P<0.05).The clinical symptoms such as abdominal pain and discomfort,nausea and vomiting,abdominal distension,peritoneal irritation and hospitalization time of the observation group were significantly shorter than those of the control group(P<0.05).There was no significant difference between the two groups before treatment about the serum TNF-α,IL-2,CRP and blood,urine amylase expression levels(P>0.05).After treatment,the inflammatory reaction related indicators and blood,urine amylase expression levels of the two groups significantly decreased(P<0.05),and the observation group decreased more significant after treatment than those of the control group after treatment(P<0.05).Conclusion:The treatment of Ulinastatin combined with Octreotide for patients with acute pancreatitis has a significant therapeutic effect,which can not only promote the clinical symptoms to improve as soon as possible,shorten the hospitalization time,but also alleviate the inflammatory reaction and reduce blood,urine amylase expression levels.
引文
[1]曾鸿英,李信健,谭伸华.奥曲肽辅助治疗急性胰腺炎的效果及对相关炎性因子的影响[J].实用临床医学,2018,19(6):17-18.
[2]朱守朝.奥曲肽对急性胰腺炎患者的临床疗效及对血液流变学、血清炎症因子的影响[J].贵州医药,2017,41(5):488-490.
[3]齐建军.奥曲肽辅助治疗急性胰腺炎患者的疗效及对血清CRP、淀粉酶水平的影响[J].黑龙江医药,2018,31(4):819-821.
[4]叶倩倩,钟继红.奥曲肽辅助治疗对急性胰腺炎患者血清CRP、淀粉酶水平影响研究[J].中国生化药物杂志,2016,36(1):106-108.
[5]郭华,陈炅,索冬卫.奥曲肽联合乌司他丁治疗急性重症胰腺炎临床疗效及安全性分析[J].中华医学杂志,2015,95(19):1471-1474.
[6]丁顺斌,闫兆平,张练,等.乌司他丁联合奥曲肽治疗老年急性重症胰腺炎患者的机制[J].中国老年学杂志,2017,37(9):2214-2216.
[7]中华医学会消化病学分会胰腺疾病学组,中华胰腺病杂志编辑委员会,中华消化杂志编辑委员会,等.中国急性胰腺炎诊治指南(2013年,上海)[J].中华消化杂志,2013,33(4):217-222.
[8]孙文栋,徐诗雄,陈实.乌司他丁和奥曲肽联合治疗重症急性胰腺炎的疗效及血流变学观察[J].中国生化药物杂志,2014,34(5):113-115.
[9]拜明军,邓桃枝,姚文娟,等.奥曲肽与乌司他丁联合治疗对重症胰腺炎患者血清内毒素和肠黏膜通透性的影响[J].徐州医科大学学报,2018,38(4):266-268.
[10]刘玉珍,吕志武.重症急性胰腺炎临床治疗的研究进展[J].胃肠病学和肝病学杂志,2017,26(5):589-593.
[11]陈敬松,刘牡丹.奥曲肽联合乌司他丁治疗急性重症胰腺炎临床疗效及安全性分析[J].海峡药学,2016,28(1):128-129.
[12]甘丹.奥曲肽注射液治疗急性胰腺炎的临床疗效分析[J].基层医学论坛,2018,22(1):28-29.
[13]宋奇峰,周建波,桑建忠,等.乌司他丁联合奥曲肽对急性胰腺炎的临床疗效及预后分析[J].中国生化药物杂志,2016,20(7):158-160.
[14]周育兰,唐蓉娥,李鹏辉,等.奥曲肽治疗急性胰腺炎57例临床疗效分析[J].中国医药导刊,2014,14(8):1247-1248.
[15]王秉.联用奥曲肽与乌司他丁治疗急性胰腺炎的临床效果分析[J].当代医药论丛,2018,16(5):134-135.
[16]杜国强,黄培铭,李达生,等.奥曲肽与乌司他丁联合治疗急性胰腺炎的疗效观察[J].锦州医科大学学报,2017,38(1):49-52.
[17]吴育美,李继昌,刘海霞,等.乌司他丁治疗急性胰腺炎的临床疗效及对患者血清炎性因子水平的影响[J].现代生物医学进展,2017,17(7):1331-1334.
[18]杨粟毅,梁成坤,翁顺元.乌司他丁联合奥曲肽对急性胰腺炎患者血清炎性因子和免疫功能的影响[J].河南医学研究,2017,26(7):1194-1196.
[19]Wang X,Zeng X,Yang B,et al.Efficacy of thymosinα1 and in a rate model[J].Mol Med Rep,2015,12(5):6775-6781.
[20]Wang G,Liu Y,Zhou S F,et al.Effect of somatostatin,ulinastatin and gabexate on the treatment of severe acute pancreatitis[J].Am J Med Sci,2016,351(5):506-512.
[2]朱守朝.奥曲肽对急性胰腺炎患者的临床疗效及对血液流变学、血清炎症因子的影响[J].贵州医药,2017,41(5):488-490.
[3]齐建军.奥曲肽辅助治疗急性胰腺炎患者的疗效及对血清CRP、淀粉酶水平的影响[J].黑龙江医药,2018,31(4):819-821.
[4]叶倩倩,钟继红.奥曲肽辅助治疗对急性胰腺炎患者血清CRP、淀粉酶水平影响研究[J].中国生化药物杂志,2016,36(1):106-108.
[5]郭华,陈炅,索冬卫.奥曲肽联合乌司他丁治疗急性重症胰腺炎临床疗效及安全性分析[J].中华医学杂志,2015,95(19):1471-1474.
[6]丁顺斌,闫兆平,张练,等.乌司他丁联合奥曲肽治疗老年急性重症胰腺炎患者的机制[J].中国老年学杂志,2017,37(9):2214-2216.
[7]中华医学会消化病学分会胰腺疾病学组,中华胰腺病杂志编辑委员会,中华消化杂志编辑委员会,等.中国急性胰腺炎诊治指南(2013年,上海)[J].中华消化杂志,2013,33(4):217-222.
[8]孙文栋,徐诗雄,陈实.乌司他丁和奥曲肽联合治疗重症急性胰腺炎的疗效及血流变学观察[J].中国生化药物杂志,2014,34(5):113-115.
[9]拜明军,邓桃枝,姚文娟,等.奥曲肽与乌司他丁联合治疗对重症胰腺炎患者血清内毒素和肠黏膜通透性的影响[J].徐州医科大学学报,2018,38(4):266-268.
[10]刘玉珍,吕志武.重症急性胰腺炎临床治疗的研究进展[J].胃肠病学和肝病学杂志,2017,26(5):589-593.
[11]陈敬松,刘牡丹.奥曲肽联合乌司他丁治疗急性重症胰腺炎临床疗效及安全性分析[J].海峡药学,2016,28(1):128-129.
[12]甘丹.奥曲肽注射液治疗急性胰腺炎的临床疗效分析[J].基层医学论坛,2018,22(1):28-29.
[13]宋奇峰,周建波,桑建忠,等.乌司他丁联合奥曲肽对急性胰腺炎的临床疗效及预后分析[J].中国生化药物杂志,2016,20(7):158-160.
[14]周育兰,唐蓉娥,李鹏辉,等.奥曲肽治疗急性胰腺炎57例临床疗效分析[J].中国医药导刊,2014,14(8):1247-1248.
[15]王秉.联用奥曲肽与乌司他丁治疗急性胰腺炎的临床效果分析[J].当代医药论丛,2018,16(5):134-135.
[16]杜国强,黄培铭,李达生,等.奥曲肽与乌司他丁联合治疗急性胰腺炎的疗效观察[J].锦州医科大学学报,2017,38(1):49-52.
[17]吴育美,李继昌,刘海霞,等.乌司他丁治疗急性胰腺炎的临床疗效及对患者血清炎性因子水平的影响[J].现代生物医学进展,2017,17(7):1331-1334.
[18]杨粟毅,梁成坤,翁顺元.乌司他丁联合奥曲肽对急性胰腺炎患者血清炎性因子和免疫功能的影响[J].河南医学研究,2017,26(7):1194-1196.
[19]Wang X,Zeng X,Yang B,et al.Efficacy of thymosinα1 and in a rate model[J].Mol Med Rep,2015,12(5):6775-6781.
[20]Wang G,Liu Y,Zhou S F,et al.Effect of somatostatin,ulinastatin and gabexate on the treatment of severe acute pancreatitis[J].Am J Med Sci,2016,351(5):506-512.