连续性血液净化治疗联合乌司他丁对急性胰腺炎患者TLR4、血浆炎症因子及白介素的影响  

Influence of TLR4,Plasma Inflammatory Cytokines and Interleukins on Acute Pancreatitis Patients Bicontinuous Blood Purification Treatment Combined with Ulinastatin

作　　者：李科[1] 刘明华[1] 张雷[1] 徐世伟[1] 尹昌林[1] 任小宝[1] 向强[1] LIKe LIU Ming-hua ZHANG Lei XU Shi-wei YIN Chang-lin REN Xiao-bao XIANG Qiang(Department of emergency, Southwest Hospital in Third Military Medical University, Chongqing, 400038, Chin)

机构地区：[1]第三军医大学西南医院急诊科,重庆400038

出　　处：《现代生物医学进展》2017年第12期2260-2263,共4页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(81071537)

摘　　要：目的:探究连续性血液净化联合乌司他丁对急性胰腺炎患者TLR4、白介素及血浆炎症因子的影响。方法:选择2014年1月至2016年1月我院接诊的72例急性胰腺炎患者,并采用随机的方法分为实验组与对照组各36例。实验组与对照组均进行基础治疗和乌司他丁治疗,而实验组还要进行连续性血液净化治疗。记录治疗后APACHEⅡ评分、住院时间、腹痛消失时间、血清淀粉酶恢复时间,测量患者治疗前和治疗一周后的TLR4、血浆炎症因子及白介素水平。结果:(1)实验组患者治疗后住院时间、血清淀粉酶恢复时间、APACHEⅡ评分、腹痛消失时间均显著低于或少于对照组患者(P<0.05)。(2)相较于治疗前,两组患者治疗一周后的TLR4、CRP、IL-6和TNF-α水平均显著降低(p<0.05);实验组患者治疗一周后的TLR4、CRP、IL-6和TNF-α的水平均显著低于对照组(p<0.05)。(3)实验组的治愈率(34.29%)和总有效率(74.29%)均显著高于对照组的治愈率(14.29%)和总有效率(48.57%)。结论:连续性血液净化治疗联合乌司他丁对急性胰腺炎患者的抗炎效果相较于单独使用乌司他丁疗效显著,能更好地降低炎症反应,使得TLR4、血浆炎症因子及白介素等炎症因子降低。Objective： In order to study the influence of TLR4, plasma inflammatory cytokines and interleukins on acute pancreatitis patients bicontinuous blood purification treatment combined with ulinastatin. Methods： From January 2014 to 2016 January, 72 cases of patients who with acute pancreatitis admitted to our hospital ,and it was randomly divided into observation group and control group, each of 36 cases. In the control group based on the foundation treatment with ulinastatin treatment, while the observation group in the control group therapy based on the use of continuous blood purification treatment. Recorded after treatment, APACHE Ⅱ score, hospitalization time, abdominal pain disappearing time, serum amylase recovery time, were measured the level of before treatment and after a week of treatment of TLR4, plasma inflammatory factors and interleukin. Results： （1） Observation group after treatment APACHE 17 score, length of stay, abdominal pain disappeared time, serum amylase recovery time were significantly lower than or less than the control group （P〈0.05）. （2）The levels of TLR4, CRP, IL-6 and TNF-α in the two groups after treatment were significantly lower than those before treatment （p〈0.05）; The levels ofTLR4, CRP, IL-6 and TNF-α in the observation group were significantly lower than those in the control group （9〈0.05） after one week treatment. （3）The cure rate （34.29%） and total effective rate （74.29%） in the observation group were significantly higher than that in the control group （14.29%） and total effective rate （48.57%）. Conclusion： Compared to the single use of ulinastatin and continuous blood purification treatment combined with ulinastatin on the treatment of patients with acute pancreatitis effect significantly, can reduce the inflammatory reaction and the TLR4, plasma inflammatory factor and interleukin inflammatory factors.

关 键 词：乌司他丁 急性胰腺炎 炎症因子 血液净化治疗 

分 类 号：R576[医药卫生—消化系统]