乌司他丁治疗急性重症胰腺炎的疗效及对血清炎症因子水平的影响  

Clinical Efficacy of Ulinastatin on Treatment of Severe Acute Pancreatitis and Its Influence on Serum Levels of Inflammatory Cytokines

作　　者：张东[1] 孙振棣[2] 吴宝强[1] 

机构地区：[1]江苏省常州市第一人民医院肝胆外科,常州市213003 [2]山东省滨州市滨州医学院附属医院普外科,滨州市256603

出　　处：《广西医学》2013年第12期1646-1648,共3页Guangxi Medical Journal

摘　　要：目的观察乌司他丁治疗急性重症胰腺炎的疗效,探讨其对血清炎症因子水平的影响。方法将急性重症胰腺炎患者60例按随机数字表法分成两组,对照组30例采用基础治疗,观察组30例在此基础上静脉滴注乌司他丁10万U/d,连续7d。采用动态急性生理和慢性健康状况评分系统(APACHEⅡ)对两组患者治疗前后病情进行评分,同时检测平均动脉压(MAP)、心率(HR)、降钙素原(PCT)、C反应蛋白(CRP)、血肌酐(Cr)及白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)、肿瘤坏死因子(TNF-α)水平。结果治疗1、3、5、7 d后观察组APACHEⅡ评分显著低于对照组(P<0.05)。治疗1 d及7 d后观察组MAP显著高于对照组(P<0.05),而HR、PCT、CRP、Cr则显著低于对照组(P<0.05);观察组IL-10显著高于对照(P<0.05),而IL-6、IL-8、TNF-α则显著低于对照组(P<0.05)。结论加载乌司他丁治疗急性重症胰腺炎能有效调节患者血清炎症因子水平,提高疗效。Objective To observe the clinical efficacy of ulinastatin on the treatment of severe acute pancreatitis, and to investigate its influence on the serum levels of inflammatory cytokines. Methods Sixty cases of severe acute pancreatitis were randomly divided into two groups according to random number table, 30 cases in the control group received basic treatment and 30 cases in the observation group were treated with basic treatment and intravenous infusion of ulinastatin（ 100 000 U/d） for 7 days. The patients were evaluated by APACHE 11 in two groups before and after treatment as well as mean artery pressure （ MAP）, heart rate （ HR）, procalcitonin （ PCT ）, C-reactive protein （ CLIP）, creatinine （ Cr）, and the serum levels of interleukin （IL） -6, IL-8, IL-10, tumor necrosis factor （TNF）-α were detected. Results The APACHE Ⅱ scores of observation group on the lst,3rd,5th,7th day after treatment were significantly lower than those of control group（P 〈0.05）. The MAP of observation group on the lst,7th day after treatment were significantly higher than those of control group（ P 〈 0.05 ） while ttR, PCT, CRP and Cr were significantly lower than those of control group（P 〈0.05）. The serum level of IL-10 of observation group was significantly higher than that of control group（ P 〈 0.05 ）, but the serum levels of IL-6, IL-8 ,TNF-a were significantly lower than those of control group （ P 〈 0.05 ）. Conclusion The treatment combined with ulinastatin for SAP could effectively regulate the serum level of the patients＇ inflammatory cytokines and improve the clinical efficacy.

关 键 词：重症胰腺炎 乌司他丁 炎症因子 

分 类 号：R576.1[医药卫生—消化系统]