奥曲肽联合奥美拉唑对急性胰腺炎患者胃肠激素及肠道黏膜屏障功能的影响  

Impact of octreotide combined with omeprazole on gastrointestinal hormones and intestinal mucosal barrier function in patients with acute pancreatitis

作　　者：马志兰[1] 姚杰[1] 高润民 Zhi-Lan Ma;Jie Yao;Run-Min Gao(Department of Gastroenterology,People＇s Hospital of Guyuan,Guyuan 75600,Ningxia Hui Autonomous Region,Chin)

机构地区：[1]固原市人民医院消化内科,宁夏回族自治区固原市756000

出　　处：《世界华人消化杂志》2018年第20期1241-1246,共6页World Chinese Journal of Digestology

摘　　要：目的探讨奥曲肽联合奥美拉唑对急性胰腺炎(acute pancreatitis,AP)患者胃肠激素及肠道黏膜屏障功能的影响.方法选择2016-07/2017-06宁夏回族自治区固原市人民医院收治的AP患者124例为研究对象,采用随机数字表法分为观察组和对照组各62例.在常规治疗基础上,对照组同时给予奥美拉唑钠治疗,观察组同时给予奥曲肽奥美拉唑治疗.治疗2周后,比较两组患者临床疗效、临床症状、胃肠激素、肠道黏膜屏障功能、不良反应等指标.结果观察组有效率90.32%(59/62)明显高于对照组80.65%(50/62)(χ~2=6.143,P<0.05);发热、腹痛、恶心呕吐、腹胀、腹部压痛等临床症状及体征消失时间均明显短于对照组(2.12 d±0.55 d vs 4.56 d±0.72 d,1.75 d±0.42 d vs 4.34 d±0.70 d,2.23 d±0.56d vs 4.65 d±0.74 d,2.54 d±0.60 d vs 4.12 d±0.76 d,2.12 d±0.53 d vs 4.24 d±0.75 d)(t=21.205,24.982,20.533,20.185,18.177,P<0.01);血清胃动素含量明显高于对照组,胃泌素、血管活性肽含量明显低于对照组[(318.36 pg/mL±30.24 pg/mL vs 256.45 pg/mL±34.23 pg/mL),(14.12μmol/L±16.25μmol/L vs 130.24μmol/L±16.45μmol/L),(58.12 pg/mL±7.25 pg/mL vs64.36 pg/m L±8.12 pg/m L)](t=10.673,5.489,4.514,P<0.05,P<0.01);血清内毒素、D-乳酸二胺氧化酶、淀粉酶等含量明显低于对照组[(53.12 ng/L±7.25ng/L vs 64.20 ng/L±7.36 ng/L),(4.45μg/L±0.78μg/L vs 6.42μg/L±0.86μg/L),(6.47 U/L±1.12 U/L vs 9.10U/L±1.26 U/L),(124.36 U/L±24.35 U/L vs 160.21U/L±26.54 U/L)](t=8.445,13.360,12.284,7.818,P<0.05,P<0.01);不良反应8.06%(5/62)明显低于对照组24.19%(15/62)(χ~2=5.962,P<0.05).结论奥曲肽联合奥美拉唑有助于改善AP患者临床症状,提高临床疗效,减少不良反应发生,可能与调节胃肠激素、改善肠道黏膜屏障功能等因素有关.AIM To evaluate the effect of octreotide combined withomeprazole on gastrointestinal hormones and intestinal mucosal barrier function in patients with acute pancreatitis（AP）. METHODS One hundred and twenty-four patients with AP treated from July 2016 to June 2017 at People＇s Hospital of Guyuan were divided into an observation group and a control group. The control group was given omeprazole alone, and the observation group was given octreotide combined with omeprazole. Two weeks after treatment, the clinical efficacy, clinical symptoms, gastrointestinal hormones, intestinal mucosal barrier function, and adverse reactions were compared between the two groups.RESULTS The effective rate was significantly higher in the observation group than in the control group [90.32%（59/62） vs 80.65%（50/62）, χ~2 = 6.143, P 0.05）. Time to disappearance of fever, abdominal pain, nausea and vomiting, abdominal distension, abdominal tenderness, and other clinical symptoms and signs was significantly shorter in the observation group than in the control group（2.12 d ± 0.55 d vs 4.56 d ± 0.72 d, 1.75 d ± 0.42 d vs 4.34 d ± 0.70 d, 2.23 d ± 0.56 d vs 4.65 d ± 0.74 d, 2.54 d ± 0.60 d vs 4.12 d ± 0.76 d, 2.12 d ± 0.53 d vs 4.24 d ± 0.75 d; t = 21.205, 24.982, 20.533, 20.185, 18.177, P 0.01）. Serum MTL was significantly higher and serum GAS and VIP were significantly lower in the observation group than in the control group（318.36 pg/mL ± 30.24 pg/mL vs 256.45 pg/m L ± 34.23 pg/m L, 14.12 μmol/L ± 16.25 μmol/L vs 130.24 μmol/L ± 16.45 μmol/L, 58.12 pg/mL ± 7.25 pg/mL vs 64.36 pg/mL ± 8.12 pg/mL; t = 10.673, 5.489, 4.514, P 0.05 or P 0.01）. Serum ET, DLA, DAO, and AMY were significantly lower in the observation group than in the control group（53.12 ng/L ± 7.25 ng/Lvs 64.20 ng/L ± 7.36 ng/L, 4.45 μg/L ± 0.78 μg/L vs 6.42 μg/L ± 0.86 μg/L, 6.47 U/L ± 1.12 U/L vs 9.10 U/L ± 1.26 U/L, 124.36 U/L ± 24.35 U/L vs 160.21 U/L ± 26.54 U/L; t = 8.445, 13.360, 12.284, 7.818, P 0.05 or P 0.01）. T

关 键 词：急性胰腺炎 奥曲肽 奥美拉唑 胃肠激素 肠道黏膜屏障功能 

分 类 号：R576[医药卫生—消化系统]