连续性血液净化联合血必净注射液对重症急性胰腺炎患者血清AMY、GAS、LPS水平的影响  

Study on the effect of continuous blood purification combined with Xuebijing injection on serum levels of AMY,GAS and LPS in patients with severe acute pancreatitis

作　　者：秦林燕[1] 王国兴[1] 常卫华[2] 胡小舟 QIN Lin-ya;WANG Guo-xin;HANG Wei-hua(Department of Emergency,Beijing Friend Hospital,Capital Medical University,Beijing 100050,China;Department of Respiratory and Intensive Medicine,Jiaozuo People's Hospital,Jiaozuo Henan 454150,China)

机构地区：[1]首都医科大学附属北京友谊医院急诊科,北京100050 [2]河南省焦作市人民医院呼吸与危重症科,河南焦作454150 [3]郑州大学第一附属医院肾内科,河南郑州450052

出　　处：《临床和实验医学杂志》2018年第8期785-788,共4页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金资助项目(编号:81374004)

摘　　要：目的探讨连续性血液净化联合血必净注射液治疗重症急性胰腺炎(SAP)的临床效果及安全性。方法回顾性选取焦作市人民医院2014年10月至2017年8月收治的84例SAP患者作为研究对象,按照治疗方法分为观察组与对照组,每组各42例。常规治疗基础上,对照组给予连续性血液净化治疗,观察组给予连续性血液净化+血必净注射液治疗。对比两组患者症状及体征缓解情况、治疗前后血清相关因子[淀粉酶(AMY)、胃泌素(GAS)、内毒素(LPS)]水平、炎性指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)]水平、病情(APACHEⅡ)评分及安全性。结果 (1)症状、体征缓解情况:观察组恶心/呕吐、腹痛、腹胀缓解时间及体温恢复时间均较对照组短(P<0.05);(2)血清相关因子水平:两组血清AMY、GAS、LPS水平治疗前比较差异无统计学意义(P>0.05),治疗后两组血清AMY、GAS、LPS水平均较治疗前明显降低(P<0.05),且观察组血清AMY、GAS、LPS水平均较对照组低(P<0.05);(3)血清炎性指标水平:两组血清TNF-α、IL-6、CRP水平治疗前比较差异无统计学意义(P>0.05),治疗后两组血清TNF-α、IL-6、CRP水平均较治疗前明显降低(P<0.05),且观察组血清TNF-α、IL-6、CRP水平均明显低于对照组低(P<0.05);(4)病情评分:两组APACHEⅡ评分治疗前比较差异无统计学意义(P>0.05),治疗后两组APACHEⅡ评分均较治疗前明显降低(P<0.05),且观察组APACHEⅡ评分较对照组低(P<0.05);(5)安全性:观察组治疗期间不良反应发生率[7.14%(3/42)比9.52%(4/42)]与对照组比较差异无统计学意义(P>0.05)。结论连续性血液净化联合血必净注射液治疗SAP疗效显著,可有效缓解其临床症状及体征,降低血清危险因子水平,促进疾病早期转归,且具有一定的安全性。Objective To retrospectively explore the effect of continuous blood purification combined with Xuebijing injection on serum levels of AMY,GAS and LPS in patients with severe acute pancreatitis.Methods Eighty four patients with severe acute pancreatitis(SAP)during October 2014 to August 2017 in Jiaozuo People's Hospital were retrospectively selected as study objects.They were divided into observation group(42 cases)and control group(42 cases)according to random number table method.On the basis of conventional treatment,patients in control group were given with continuous blood purification for treatment,and patients in observation group were treated with continuous blood purification plus Xuebijing injection.The symptoms and signs of remission,the serum levels of related indicators[amylase(AMY),gastrin(GAS)and endotoxin(LPS)]were examined before and after the treatment,and inflammatory markers[tumor necrosis factor alpha(TNF-α)and interleukin-6(IL-6),C reactive protein(CRP)],APACHE II scores and safety of patients in these two groups were compared.Results ①The remission of symptoms and signs as nausea/vomiting,abdominal pain,abdominal distension and recovery time of patients in observation group were shorter than those of patients in control group(P<0.05).②The serum levels of related factor as AMY,GAS and LPS in patients of these two groups had no significant difference(P>0.05),and serum levels of AMY,GAS and LPS in patients of observation group were lower than those of patients in control group(P<0.05).③Levels of serum inflammatory indexes:there was no significant difference in serum levels of TNF-α,IL-6 and CRP between these two groups before treatment(P>0.05).The serum levels of TNF-α,IL-6 and CRP in these two groups were lower than those before treatment(P<0.05),and serum levels of TNF-α,IL-6 and CRP in patients of observation group were lower than those of patients in control group(P<0.05).④Disease scores:There was no significant difference in APACHE II scores between these two groups before treat

关 键 词：重症急性胰腺炎 连续性血液净化 血必净注射液 AMY GAS LPS 

分 类 号：R576[医药卫生—消化系统]