早期大剂量乌司他丁联合奥曲肽治疗对重症急性胰腺炎患者炎症因子和T淋巴细胞的影响  

Effect of early high-dose ulinastatin combined with octreotide therapy on inflammatory cytokines and T lymphocytes of patients with severe acute pancreatitis

作　　者：李科军[1] 向正国[1] 陈旭峰[1] 郑扬[1] 汤小龙[1] 

机构地区：[1]解放军第101医院(无锡市太湖医院)消化科,江苏无锡214000

出　　处：《海南医学院学报》2015年第7期929-932,共4页Journal of Hainan Medical University

基　　金：江苏省科技支撑计划(BE2012699)~~

摘　　要：目的:探讨早期大剂量乌司他汀联合奥曲肽治疗对重症急性胰腺炎患者炎症因子和T淋巴细胞的影响。方法:选择重症急性胰腺炎患者80例,按入组序列号分为观察组与对照组,各40例,两组患者均给予抗休克、补液、抗感染、及时抑制消化液等常规治疗,同期观察组给予早期大剂量乌司他丁联合奥曲肽治疗,对照组给予常规剂量乌司他丁联合奥曲肽治疗,观察两组患者治疗后炎性因子及淋巴细胞(Lym)、T淋巴细胞亚群水平变化情况。结果:观察组患者治疗3、7d血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平增高程度低于对照组,12d下降程度较对照组显著,同时白介素-10(IL-10)水平持续高于对照组,两组比较差异均有统计学意义(P<0.05);观察组患者治疗3、7、12d后Lym、CD3+、CD4+百分比及CD4+/CD8+较对照组增高明显,CD8+百分比较对照组下降明显,两组比较差异有统计学意义(P<0.05)。结论:早期大剂量乌司他丁联合奥曲肽治疗重症急性胰腺炎降低炎症因子水平,改善T淋巴细胞免疫功能更为有效。Objective： To explore the effect of early high-dose ulinastatin combined with octreotide therapy on inflammatory cytokines and T lymphocytes of patients with severe acute pancreatitis. Methods： A total of 80 patients with severe acute pancreatitis were divided into observation group and control group with 40 eases in each group. Anti-shock, rehydration, antibiotics, timely inhibit digestion and other conventional treatment were carried out. During the same period patients in the observation group were given with large doses of UTI octreotide treatment, while patients in control group received conventionaldose ulinastatin octreotide therapy. Inflammatory eytokines and lymphocytes （Lym）, T lymphocyte subsets level changes were observed. Results： 3 d and 7 d after treatment, the increase in serum CRP, TNF-α, IL-6 levels of control group was more significant that that of observation group, the 12 d degree lower than the control group decreased significantly, while IL-10 levels continue higher than the control group, the difference was statistically significant （P〈0.05）;The 3 d, 7 d, 12 d after Lym, CD3＋ ,CD4＋ percentage and CD4＋/CD8＋ of observation group patients compared with the control group increased significantly, CD8 ＋ percentages than the control group decreased significantly, the difference was statistically significant （P〈0.05）. Conclusion：Early high dose ulinastatin octreotide treatment of severe acute pancreatitis reduce levels of inflammatory factors, improve the immune function of T lymphocytes more effective.

关 键 词：乌司他丁 奥曲肽 重症急性胰腺炎 炎症因子 T淋巴细胞 

分 类 号：R576[医药卫生—消化系统] R657.51[医药卫生—内科学]