生长抑素对急性胰腺炎患者血浆瘦素水平的影响  

Effect of Somatostatin on the Serum Level of Leptin in Patient with Acute Pancreatitis

作　　者：詹海勇[1] 詹琼[2] 詹冬雪[1] 黄聪武[1] 李国平 

机构地区：[1]汕头大学医学院第二附属医院,广东省汕头市515041 [2]汕头大学医学院第一附属医院

出　　处：《中国全科医学》2012年第12期1391-1393,共3页Chinese General Practice

基　　金：广东省卫生厅立项课题(A2010408)

摘　　要：目的探讨生长抑素对急性胰腺炎患者血浆瘦素水平的影响及血浆瘦素水平与炎性因子的相关性。方法收集108例轻型急性胰腺炎患者,随机分为A组和B组各54例,两组患者除给予常规治疗外,A组给予生长抑素(思他宁3 mg+0.9%氯化钠注射液48 ml,上述配液静脉注射4 ml后以4 ml/h恒速泵入)维持48 h,B组给予生长抑素(思他宁3 mg+0.9%氯化钠注射液48 ml,静脉注射0.9%氯化钠注射液4 ml后上述配液以4 ml/h恒速泵入)维持48 h。分别于入院时和生长抑素维持48 h后检测两组患者血浆瘦素、白介素1、肿瘤坏死因子α和髓过氧化物酶水平。同时收集30例健康者为对照组。结果 (1)与对照组比较,两组胰腺炎患者血浆瘦素水平均明显降低,而白介素1、肿瘤坏死因子α和髓过氧化物酶水平明显升高(P<0.05);(2)经生长抑素治疗48 h,两组胰腺炎患者血浆各指标均较前改善,A组改善程度优于B组(P<0.05);(3)Pearson相关分析显示,急性胰腺炎患者血浆瘦素水平与白介素1、肿瘤坏死因子α和髓过氧化物酶均呈负相关。结论静脉注射后再给予恒速泵入生长抑素能更好地上调急性胰腺炎患者血浆瘦素水平,下调炎性因子水平;血浆瘦素水平与炎性因子呈负相关,血浆瘦素水平在急性胰腺炎早期可能具有改善机体炎症反应的作用。Objective To investigate the effect of somatostatin on the serum level of leptin （LP） in patients with a- cute pancreatitis and the relationship between LP and inflammatory cytokines. Methods 108 patients diagnosed as acute mild pancreatitis were randomly divided into group A （n = 54） and group B （n = 54 ）. Besides offering the patients in both groups the conventional treatment, we also administrated group A somatostatin （ Stilamin 3 mg ＋ NS 48 ml, 4 ml bolus then 4 ml pump/ h） for 48 h, while group B somatostatin （ Stilamin 3 mg ＋ NS 48 ml, 4 ml NS bolus then 4 ml pump/h） for 48 h. Serum levels of LP, IL- 1, TNF- ct, and MPO were evaluated on admission and at the end of 48 hours＇ somatostatin treatment. 30 healthypeople were enrolled as control group. Results （ 1 ） Compared with that in the control group, serum level of LP in both acute pancreatitis groups were lowered while IL - 1, TNF - or, and MPO were elevated obviously （ P 〈 0.05 ） ; （2） After 48 h of Sti- lamin treatment, the indices of blood plasma in both acute pancreatitis groups were improved, and the indices in group A were better than those in group B （P 〈 O. 05） ; （3） Serum level of LP was negatively correlated with IL - 1, TNF - ct, and MPO as indicated by Pearson correlation. Conclusion Continual intravenous pump of Stilamin after bolus has better effect on up - regu- lation of LP and down - regulation of inflammatory cytokines ; Serum level of leptin is negatively correlated to inflammatory eyto- kines and may improve inflammatory reaction of our bodies in the early stage of acute pancreatitis.

关 键 词：胰腺炎 急性 生长抑素 瘦素 

分 类 号：R576.1[医药卫生—消化系统]