非诺贝特联合血液滤过治疗高脂血症性胰腺炎的临床效果
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摘要
目的:探讨非诺贝特联合血液滤过治疗高脂血症性胰腺炎患者的临床疗效。方法:选取2012年2月至2018年3月我院收治110例高脂血症性胰腺炎患者,研究分为常规治疗组43例,血液滤过组32例:在常规治疗基础上予血液滤过治疗;联合治疗组35例:常规治疗基础上血液滤过联合非诺贝特治疗。比较三组腹痛平均消失时间、平均住院时间、血C-反应蛋白(CRP)、甘油三酯(TG)、血清淀粉酶(AMP)水平变化情况。结果:联合治疗组患者治疗总有效率为88.57%(31/35),显著高于血液滤过组84.38%(27/32)及常规治疗组72.09%(31/43),差异有统计学意义(P<0.05);联合治疗组患者腹痛平均消失时间及平均住院时间分别为(4.3±1.2) d、(9.6±1.4) d,均明显短于血液滤过组(5.9±1.8) d、(11.3±1.8) d以及常规治疗组(6.8±1.1) d、(14.2±1.3) d,差异均有统计学意义(P<0.05);治疗5 d后联合治疗组患者的CRP、TG及AMP水平分别为(6.3±2.2) mg/L、(4.3±2.3) mmol/L、(421.3±97.2) U/L,均明显低于血液滤过组的(12.7±2.4) mg/L、(10.2±2.9) mmol/L、(475.8±83.5) U/L及常规治疗组的(16.2±1.6) mg/L、(14.9±2.4) mmol/L、(513.7±96.4) U/L,差异均有统计学意义(P<0.05)。结论:在常规治疗基础上非诺贝特联合血液滤过治疗可提高高脂血症性胰腺炎临床效果,值得进一步推广应用。
Objective:To study the efficacy of hemofiltration combined with fenofibrate in the treatment of patients with hyperlipidemic acute pancreatitis(AP). Methods: A total of 110 patients with hyperlipidemia AP admitted to our hospital from February 2012 to March 2018 were selected and divided into three groups. 43 patients were conventional treatment; 32 cases in the hemofiltration group were given conventional treatment combined with the hemofiltration therapy; 35 cases in the combined therapy group were given conventional treatment, hemofiltration therapy and fenofibrate. The average abdominal pain disappear time, average hospital stay time and the level changes of C-reactive protein(CRP), fasting triglyceride(TG) and serum amylase(AMP) in the three groups were compared. Results: The total effective rate of the patients in the combined therapy group was 88.57 %(31/35), which was significantly higher than that in the hemofiltration group(84.38 %, 27/32) and conventional treatment group(72.09 %, 31/43)(P<0.05). The average abdominal pain disappear time and hospitalization time of the combined therapy group were respectively(4.3±1.2) d and(9.6±1.4) d, which were significantly less than those of the hemofiltration group {(5.9±1.8)d,(11.3±1.8)d}and conventional treatment group{(6.8±1.1)d,(14.2±1.3)d}(P<0.05). 5 days after the treatment, the levels of CRP, TG and AMP in the combined therapy group were respectively(6.3±2.2) mg/L,(4.3±2.3) mmol/L and(421.3±97.2) U/L, which were significantly lower than those in the hemofiltration group{(12.7±2.4)mg/L,(10.2±2.9)mmol/L and(475.8±83.5)U/L}and conventional treatment group{(16.2±1.6) mg/L,(14.9±2.4)mmol/L and(513.7±96.4)U/L}(P<0.05). Conclusion: Additional hemofiltration and fenofibrate based on the conventional treatment have the remarkable clinical efficiency in the treatment of hyperlipidemic AP, which is worthy of popularization and application.
Objective:To study the efficacy of hemofiltration combined with fenofibrate in the treatment of patients with hyperlipidemic acute pancreatitis(AP). Methods: A total of 110 patients with hyperlipidemia AP admitted to our hospital from February 2012 to March 2018 were selected and divided into three groups. 43 patients were conventional treatment; 32 cases in the hemofiltration group were given conventional treatment combined with the hemofiltration therapy; 35 cases in the combined therapy group were given conventional treatment, hemofiltration therapy and fenofibrate. The average abdominal pain disappear time, average hospital stay time and the level changes of C-reactive protein(CRP), fasting triglyceride(TG) and serum amylase(AMP) in the three groups were compared. Results: The total effective rate of the patients in the combined therapy group was 88.57 %(31/35), which was significantly higher than that in the hemofiltration group(84.38 %, 27/32) and conventional treatment group(72.09 %, 31/43)(P<0.05). The average abdominal pain disappear time and hospitalization time of the combined therapy group were respectively(4.3±1.2) d and(9.6±1.4) d, which were significantly less than those of the hemofiltration group {(5.9±1.8)d,(11.3±1.8)d}and conventional treatment group{(6.8±1.1)d,(14.2±1.3)d}(P<0.05). 5 days after the treatment, the levels of CRP, TG and AMP in the combined therapy group were respectively(6.3±2.2) mg/L,(4.3±2.3) mmol/L and(421.3±97.2) U/L, which were significantly lower than those in the hemofiltration group{(12.7±2.4)mg/L,(10.2±2.9)mmol/L and(475.8±83.5)U/L}and conventional treatment group{(16.2±1.6) mg/L,(14.9±2.4)mmol/L and(513.7±96.4)U/L}(P<0.05). Conclusion: Additional hemofiltration and fenofibrate based on the conventional treatment have the remarkable clinical efficiency in the treatment of hyperlipidemic AP, which is worthy of popularization and application.
引文
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[10] 张娟,沈沪佳,王超,等.糖原累积症合并高脂血症性胰腺炎致区域性门脉高压1例报告[J].中国临床医学,2018,25(1):147-151.
[11] 丁鲲,苏东东,周露,等.连续性静脉-静脉血液滤过联合血液灌流治疗高三酰甘油血症胰腺炎患者的临床疗效观察[J].中国中西医结合急救杂志,2018,(1):76-80.
[12] 左小淑,余追,周晨亮.血液灌流联合连续静脉-静脉滤过治疗高脂血症性重症急性胰腺炎疗效观察[J].微循环学杂志,2017,(1):20-23.
[13] Chu KE,Fong Y,Wang D,et al.Pretreatment of a matrix metalloproteases inhibitor and aprotinin attenuated the development of acute pancreatitis-induced lung injury in rat model[J].Immunobiology.2018;223(1):64-72.
[14] 李亮,程三放,乔万海.乌司他丁联合奥曲肽对急性胰腺炎患者细胞因子的影响[J].西部医学,2017,29(10):1401-1405.
[2] 王银凤,陶晓根,郭伟,等.连续性静脉-静脉血液透析滤过在高脂血症重症胰腺炎治疗中的应用[J].肝胆外科杂志,2017,(5):342-344.
[3] Xiang JX,Hu LS,Liu P,et al..Impact of cigarette smoking on recurrence of hyperlipidemic acute pancreatitis[J].World J Gastroenterol.2017;23(47):8387-8394.
[4] Weber ML.Can fenofibrate influence Pregnancies at High-risk for Preeclampsia?[J].Z Geburtshilfe Neonatol.2018;222(1):31-33.
[5] 冯晓东,张世杨,向容,等.血液灌流联合血液透析滤过治疗高脂血症性急性胰腺炎临床观察[J].四川医学,2017,(3):316-318.
[6] Yang L,Zhao Z,Zhou K,et al..Acute hyperlipidemic pancreatitis accompanied by chylous ascites with normal amylase and lipase in pregnancy[J].J Clin Lipidol.2017;11(4):1091-1094.
[7] 林晚,张旭,张飞雄,等.中国人群高脂血症性急性胰腺炎与急性胆源性胰腺炎临床特征的Meta分析[J].宁夏医科大学学报,2017,(9):1085-1090.
[8] Zhu Y,Pan X,Zeng H,et al..A Study on the Etiology,Severity,and Mortality of 3260 Patients With Acute Pancreatitis According to the Revised Atlanta Classification in Jiangxi,China Over an 8-Year Period[J].Pancreas.2017;46(4):504-509.
[9] 郑丹,蒋永泼,张胜,等.高脂血症重症急性胰腺炎的临床特征分析[J].浙江医学,2017,(22):2002-2004.
[10] 张娟,沈沪佳,王超,等.糖原累积症合并高脂血症性胰腺炎致区域性门脉高压1例报告[J].中国临床医学,2018,25(1):147-151.
[11] 丁鲲,苏东东,周露,等.连续性静脉-静脉血液滤过联合血液灌流治疗高三酰甘油血症胰腺炎患者的临床疗效观察[J].中国中西医结合急救杂志,2018,(1):76-80.
[12] 左小淑,余追,周晨亮.血液灌流联合连续静脉-静脉滤过治疗高脂血症性重症急性胰腺炎疗效观察[J].微循环学杂志,2017,(1):20-23.
[13] Chu KE,Fong Y,Wang D,et al.Pretreatment of a matrix metalloproteases inhibitor and aprotinin attenuated the development of acute pancreatitis-induced lung injury in rat model[J].Immunobiology.2018;223(1):64-72.
[14] 李亮,程三放,乔万海.乌司他丁联合奥曲肽对急性胰腺炎患者细胞因子的影响[J].西部医学,2017,29(10):1401-1405.