奥曲肽与乌司他丁联合治疗对重症胰腺炎患者血清内毒素和肠黏膜通透性的影响  

Study on the influence of ulinastatin and octreotide on the serum endotoxin and intestinal permeability of severe acute pancreatitis patients

作　　者：拜明军[1] 邓桃枝[1] 姚文娟[1] 蓝程[1] 毛苇[1] 赵心恺[1] 韩向阳[1] BAI Mingjun;DENG Taozhi;YAO Wenjuan;LAN Cheng;MAO Wei;ZHAO Xinkai;HAN Xiangyang(Department of Gastroenterology, Hainan People＇s Hospital, Haikou, Hainan 570311, China)

机构地区：[1]海南省人民医院消化内科,海南海口570311

出　　处：《徐州医科大学学报》2018年第4期266-268,共3页Journal of Xuzhou Medical University

摘　　要：摘要：目的：观察分析奥曲肽与乌司他丁联合治疗对重症胰腺炎患者血清内毒素和肠粘膜通透性的影响。方法：随机选取2015年1月~2016年6月于我院就诊的重症胰腺炎患者88例，采用数字随机法均分为观察组（n=44）与对照组（n=44），对照组患者给予奥曲肽治疗，观察组患者给予奥曲肽联合乌司他丁治疗，观察两组患者治疗前后的血清内毒素水平、hs-CRP、肠粘膜通透性。结果：治疗前，两组患者的内毒素、hs-CRP、血浆DAO浓度、L/M比值对比差异不显著，无统计学意义（P〉0.05）；治疗后，两组患者的内毒素水平、hs-CRP显著低于治疗前（P〈0.05），两组患者的血浆DAO浓度显著低于治疗前（P〈0.05），L/M比值显著高于治疗前（P〈0.05）；且观察组患者的内毒素水平、hs-CRP、血浆DAO浓度显著低于对照组（P〈0.05），L/M比值显著低于对照组（P〈0.05）。结论：采用奥曲肽联合乌司他丁治疗重症胰腺炎患者，能够显著降低患者的血清内毒素水平，且能够帮助恢复患者的肠粘膜屏障功能。Objective To observe the effects of ulinastatin combined with octreotide on the serum endotoxin and intestinal permeability of severe acute pancreatitis patients. Methods A total of 88 patients with severe acute panereatitis who were admitted into our hospital from January 2015 to Jun 2016 were randomly selected and divided into an observation group and a control group （n = 44）. The control group were treated with octreotide, while the observation group received a combined treatment of octreofide and ulinastatin. Their levels of serum endotoxin, high sensitive - CRP （ hs - CRP）, and intestinal mucosal permeability before and after treatment were observed. Results Before treatment, no statistical difference was found as to endotoxin, hs -CRP, plasma DAO concentrations and the ratio of lactulose to mannitol （L/M） between the two groups （P 〉 0.05 ）. After treatment, the two groups produced marked decreases in the levels of endotoxin and hs - CRP and plasma DAO concentrations, and significant increases in L/M ratio, compared with those before treatment （P 〈 0.05 ）. Meanwhile, the observation group showed reduced levels of endotoxin, hs -CRP, plasma DAO concentrations and L/M ratio than the control （ P 〈 0.05）. Conclusions The combined use of octreotide and ulinastatin in the treatment of patients with severe acute pancreatitis, can significantly decrease the level of serum endotoxin, and can help restore intestinal mucosal barrier function in patients.

关 键 词：重症胰腺炎 奥曲肽 乌司他丁 血清内毒素 肠黏膜通透性 

分 类 号：R576[医药卫生—消化系统]