艾司奥美拉唑钠对重症急性胰腺炎患者肠黏膜屏障功能及炎性反应的影响  

Effects of Estradiol Sodium on Intestinal Mucosal Barrier Function and Inflammatory Response in Patients with Severe Acute Pancreatitis

作　　者：马忠伟[1] 王秋玲[2] 黄东力[3] 

机构地区：[1]山东省昌邑市人民医院集中采购办公室,山东昌邑261300 [2]山东省昌邑市人民医院普外一科,山东昌邑261300 [3]山东省昌邑市人民医院普外二科,山东昌邑261300

出　　处：《中国医药指南》2017年第17期12-13,15,共3页Guide of China Medicine

摘　　要：目的探讨艾司奥美拉唑钠对重症急性胰腺炎(severe acute pancreatitis,SAP)的临床疗效。方法采用回顾性分析法,将本院收治的102例SAP患者根据治疗方法进行分组:A组(肠外营养组)、B组(肠内营养组)、C组(艾司奥美拉唑钠+肠内营养组)。各组入院后均进行基础治疗,在此基础上A组给予肠外营养治疗,B组给予早期肠内营养治疗,C组在B组治疗基础上加用质子泵抑制剂艾司奥美拉唑钠。疗程均为14 d。各组治疗前、治疗后7 d时采用比浊法检测血浆内毒素水平,采用酶学分光光度法检测血浆D-乳酸、二胺氧化酶水平。采用酶联免疫吸附法(ELISA法)检测血清白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、高敏C反应蛋白(hs-CRP)水平。比较各组治疗前后APACHEⅡ评分,观察并比较各组患者继发感染率、手术率、病死率、住院时间、住院费用。结果 B、C组治疗后血浆内毒素、D-乳酸、二胺氧化酶、IL-6、IL-8、TNF-α、hs-CRP水平、APACHEⅡ评分明显低于A组,经比较差异有统计学意义(P<0.01)。C组治疗后血浆内毒素、D-乳酸、二胺氧化酶、IL-6、IL-8、TNF-α、hs-CRP水平、APACHEⅡ评分明显低于B组,经比较差异有统计学意义(P<0.01)。C组继发感染率、手术率、病死率均明显低于A、B组,平均住院时间与平均住院费用均明显少于A、B组,经比较差异有统计学意义(P<0.01)。结论艾司奥美拉唑钠联合早期肠内营养治疗能明显改善患者肠道黏膜屏障功能,下调机体炎症水平,对SAP的疗效更显著、更稳定。Objective To explore the influence of Esomeprazole Sodium on severe acute pancreatitis. Methods Using retrospective analysis method, 102 patients with SAP were divided into group A（parenteral nutrition） and group B（enteral nutrition）, group C（enteral nutrition＋Esomeprazole Sodium）.Before and after treatment, using turbidimetric method to detect the plasma endotoxin level, enzymatic spectrophotometry to detect the plasma D-lactic acid, diamine oxidase level. Using ELISA method to detect the serum IL-6, IL-8, TNF-α, hs-CRP levels. Comparison the APACHE Ⅱ score, secondary infection, operation rate, mortality, length of hospital stay, hospital expenses Results After treatment, C group of plasma endotoxin, D-lactic acid, diamine oxidase, IL-6, IL-8, TNF-α, hs-CRP level, the APACHE Ⅱ score was lower than that group A and B（P〈0.01）. Secondary infection rate, operation rate, mortality rate was lower in group C than group A, B. In group C The average hospitalization time and average hospitalization expenses were significantly less than group A, B（P〈0.01）. Conclusion Esomeprazole Sodium with early enteral nutrition therapy can obviously improve the intestinal mucosal barrier function, cut the body inflammation levels, curative effect is more significant and more stable for SAP.

关 键 词：艾司奥美拉唑钠 重症急性胰腺炎 炎症 肠黏膜 

分 类 号：R576[医药卫生—消化系统]