乌司他丁对重症急性胰腺炎患者肠道黏膜屏障功能的影响  

Effect of Ulinastatin on the intestinal mucosal barrier function in patients with severe acute pancreatitis

作　　者：姜志明[1] 鲁召欣 张明[1] 孙楠楠[1] 张众慧[1] 杨君[1] 徐拥庆[1] 李涛[1] 解建[1] 

机构地区：[1]山东省千佛山医院重症医学科,山东济南250014 [2]青岛市海慈医疗集团急诊科,山东青岛266033

出　　处：《中国医药导报》2011年第13期16-17,21,共3页China Medical Herald

摘　　要：目的:观察乌司他丁对重症急性胰腺炎患者肠道黏膜屏障功能的影响。方法:将57例急性重症胰腺炎患者随机分为治疗组(29例)和对照组(28例)。两组患者治疗过程中监测其血浆D-乳酸水平、尿乳果糖/甘露醇(L/M)值,观察重症胰腺炎患者ARDS、MODS发生率的情况。两组均给予常规治疗。治疗组在此基础上联合乌司他丁治疗,分别观察两组患者治疗后第7天、14天D-乳酸水平、L/M值的变化。结果:治疗7 d及14 d后,治疗组较对照组D-乳酸水平均明显降低[(6.02±1.01)μg/L vs(8.86±0.75)μg/L、(3.77±0.82)μg/L vs(7.20±0.91)μg/L](P<0.01);治疗14 d后,较对照组尿L/M值水平明显降低(0.048 0 vs 0.071 3)(P<0.05)。治疗结束后,治疗组ARDS及MODS发生率较对照组均有显著降低(17.2%vs 50.0%、0 vs 25.0%)(P<0.01);治疗组较对照组28 d病死率明显降低(10.3%vs 32.1%)(P<0.05)。结论:乌司他丁能改善重症急性胰腺炎患者肠道黏膜屏障功能,降低肠道细菌、内毒素移位,并能降低重症急性胰腺炎患者ARDS、MODS的发生率及28 d病死率。Objective： To observe the effect of Ulinastatin on the intestinal mucosal barrier function in patients with severe acute pancreatitis.Methods： 58 cases of severe acute pancreatitis were randomly divided into treatment group（29 cases） and control group（28 cases）.During treatment,the level of plasma D-lactic acid,urinary Lactulose/Mannitol（L/M） values were detected,ARDS and MODS incidence rate were observed in patients.Both groups were given to conventional treatment.Treatment group was added with Ulinastatin besides conventional treatment.Two groups of patients were observed on D-lactate levels,L/M value changes after treated 7 days and 14 days.Results： After treated 7 days and 14 days,compared with the control group,the D-lactate levels of treatment group were significantly lower[（6.02±1.01） μg/L vs（8.86±0.75） μg/L,（3.77±0.82） μg/L vs（7.20±0.91） μg/L]（P0.01）;treatment after 14 days,the urinary L/M level of treatment group was significantly lower than the control group（0.048 0 vs 0.071 3）（P0.05）.After the end of treatment,ARDS and MODS incidence rate were significantly lower（17.2% vs 50.0%,0 vs 25.0%）（P0.01）;the 28-day mortality of treatment group decreased significantly than the control group＇s（10.3% vs 32.1%）（P0.05）.Conclusion： Ulinastatin can improve the severe acute pancreatitis patients＇ intestinal mucosa barrier function,reduce intestinal bacteria and endotoxin translocation,and reduce ARDS and MODS incidence and 28-day mortality of severe acute pancreatitis.

关 键 词：乌司他丁 急性重症胰腺炎 肠道黏膜屏障功能 

分 类 号：R657.51[医药卫生—外科学]