前列地尔注射液对急性胰腺炎患者肠黏膜屏障功能的保护作用  

Protective effect of alprostadil injection on intestinal mucosal barrier function in patients with acute pancreatitis

作　　者：赵振中[1] 谢中华[1] 汪铁军[1] 郑元秀[1] 黄芳芳[1] Zhao Zhenzhong;Xie Zhonghua;Wang Tiejun;Zheng Yuanxiu;Huang Fangfang(Department of Medicine, Yuhang District Second People＇s Hospital of Hangzhou City, Hangzhou 311121, China)

机构地区：[1]杭州市余杭区第二人民医院内二科,杭州311121

出　　处：《中华胰腺病杂志》2018年第1期16-19,共4页Chinese Journal of Pancreatology

摘　　要：目的观察前列地尔注射液对急性胰腺炎（AP）患者肠黏膜屏障功能的保护作用。方法选取2016年5月至2017年3月浙江杭州市余杭区第二人民医院消化内科收治的AP患者78例，按数字表法随机分为对照组38例和治疗组40例，对照组予AP常规治疗，治疗组在此基础上予前列地尔注射液10 μg/d静脉滴注，连续14 d。选取同期40名健康体检者作为健康组。记录患者入院当日及治疗结束后第2天的MCTSI评分及APACHEⅡ评分。采用酶联免疫吸附试验法（ELISA）测定血清二胺氧化酶（DAO）、内毒素（ET）及肠脂肪酸结合蛋白（IFABP）水平。结果治疗组和对照组患者治疗前MCTSI、APACHEⅡ评分及血清DAO、ET、IFABP水平差异均无统计学意义（P值均〉0.05），但比健康组显著升高（P值均〈0.01）。治疗后，两组患者MCTSI、APACHEⅡ评分及血清DAO、ET、IFABP水平均较治疗前明显下降（P〈0.05或〈0.01）；治疗组患者MCTSI、APACHEⅡ评分及血清DAO、ET、IFABP水平均较对照组下降明显[（3.78±0.43）分比（5.89±0.13）分，（5.65±1.77）分比（9.05±1.61）分，（2.18±0.16）U/ml比（3.22±0.15）U/ml，（0.15±0.06）EU/ml比（0.25±0.09）EU/ml，（62.01±12.82）ng/L比（85.43±16.79）ng/L，P值均〈0.05]。AP患者的血清DAO、ET及IFABP水平与MCTSI、APACHEⅡ评分均呈明显正相关（P值均〈0.01）。结论AP患者存在明显的肠黏膜屏障功能损伤，前列地尔注射液可通过保护肠黏膜屏障功能在一定程度上改善AP患者临床症状及CT评分。ObjectiveTo observe the effects of alprostadil injection on intestinal mucosal barrier function in patients with acute pancreatitis（AP）.MethodsSeventy-eight AP patients admitted in Department of Medicine in Yuhang District Second People′s Hospital of Hangzhou City from May 2016 to March 2017 were divided into 2 groups using random number method, including 38 cases in the control group and 40 cases in the treatment group. Patients in the control group received routine treatment. Patients in the treatment group were given intravenous 10 μg/d alprostadil injection in addition to routine treatment continuously for 14 days. Another 40 healthy volunteers who underwent routine examination in the same period were enrolled as healthy control group. The scores of MCTSI and APACHEⅡ were recorded at admission and 2 days after the treatment. The levels of serum DAO, endotoxin （ET） and IFABP were detected by ELISA.ResultsThere were no significant difference on the scores of MCTSI and APACHEⅡ, the levels of serum DAO, ET, IFABP before treatment between control and treatment group（P〉0.05）, but were increased significantly than those in the healthy control group（P〈0.01）. After treatment, the scores of MCTSI and APACHEⅡ, the levels of serum DAO, ET, IFABP were decreased significantly than those before treatment in two groups（P〈0.05 or P〈0.01）, but the scores of MCTSI and APACHEⅡ, the levels of serum DAO, ET and IFABP were decreased significantly than those in the control group（3.78±0.43）vs （5.89±0.13）, （5.65±1.77）vs （9.05±1.61）, （2.18±0.16）U/ml vs （3.22±0.15）U/ml, （0.15±0.06）EU/ml vs （0.25±0.09）EU/ml, （62.01±12.82）ng/L vs （85.43±16.79）ng/L; all P〈0.05）. There was a significant positive correlation between serum DAO, ET, IFABP and the scores of MCTSI （P〈0.01）. There was a significant positive correlation between serum DAO, ET, IFABP and the scores of APACHEⅡ, too （P〈0.01）.ConclusionsPatient with acute pancreatitis have obvious

关 键 词：肠黏膜屏障功能 前列地尔注射液 急性胰腺炎 保护作用 APACHEⅡ评分 患者 血清二胺氧化酶 酶联免疫吸附试验法 

分 类 号：R576[医药卫生—消化系统]