综合治疗对急性重症胰腺炎患者血清sTREM-1及尿液CAPAP水平影响的前瞻性研究  

Effect of comprehensive treatment on serum sTREM-1 and urinary CAPAP levels in patients with acute severe pancreatitis

作　　者：李伟 李莉[1] LI Wei;LI Li(Department of Emergency Internal Medicine,the First College of Clinical Medical Science,China Three Gorges University/Yichang Central People′s Hospital,Yichang,Hubei 443003,China)

机构地区：[1]三峡大学第一临床医学院/宜昌市中心人民医院急诊内科

出　　处：《国际检验医学杂志》2019年第24期3049-3053,共5页International Journal of Laboratory Medicine

摘　　要：目的观察综合治疗对急性重症胰腺炎患者血清可溶性髓系细胞触发受体-1(sTREM-1)和尿液羧肽酶B激活肽(CAPAP)水平影响。方法收集2016年2月至2017年4月在该院治疗的重型急性胰腺炎患者80例作为研究对象,使用随机数字表分为对照组和研究组,每组40例,研究组患者进行生长抑素和泮托拉唑钠联合治疗,对照组患者给予常规支持性治疗。治疗7 d后,观察两组患者治疗效果、症状改善情况、治疗前后血清sTREM-1及尿液CAPAP水平、生存率、凝血功能及不良反应之间的差异。结果经过7 d的治疗,研究组患者的总有效率(75.00%)高于对照组(52.50%),差异有统计学意义(χ^2=4.381,P=0.036),腹痛缓解时间[(1.91±0.88)d]、脱离呼吸机时间[(3.31±0.37)d]、肠道恢复时间[(2.61±0.78)d]、血液淀粉酶恢复时间[(3.33±0.39)d],明显小于对照组[分别为(2.44±0.91)d,(5.42±0.45)d、(5.51±1.01)d、(6.12±0.97)d],差异有统计学意义(P<0.05);两组患者的血清活化部分凝血酶原时间(APTT)、凝血酶原时间(PT)、sTREM-1及尿液CAPAP水平均有明显下降,研究组血清sTREM-1及APTT、PT、尿液CAPAP阳性率显著低于对照组,差异有统计学意义(P<0.05)。研究组和对照组不良反应比较,差异无统计学意义(P>0.05)。结论生长抑素和泮托拉唑的联合使用,在重型胰腺炎患者的治疗中,疗效显著,有效改善患者胃肠道PH环境,加强对胰蛋白酶分泌的抑制,血清中sTREM-1及尿液CAPAP水平明显下降,降低患者病死率,值得在临床工作中进行推广。Objective To observe the effects of comprehensive treatment on serum soluble myeloid cells trigger receptor-1(sTREM-1)and urinary carboxypeptidase B activating peptide(CAPAP)levels in patients with acute severe pancreatitis.Methods 80 patients with severe acute pancreatitis treated in a hospital from February 2016 to April 2017 were divided into control group and research group with random number table.40 patients in each group were treated with somatostatin and pantoprazole sodium.The patients in control group were given routine supportive treatment.After 7 days of treatment,the difference of therapeutic effect,improvement of symptoms,serum sTREM-1 and urinary CAPAP levels,survival rate,coagulation function and adverse reactions between the two groups were observed.the function of coagulation and the adverse reactions were observed after seven days of treatment.Results After 7 days,the total efficiency of patients in the study group(75.00%)was higher than the control group(52.50%),the difference was statistically significant(χ^2=4.381,P=0.036).Abdominal pain remission time[(1.91±0.88)d],ventilator time[(3.31±0.37)d],intestinal recovery time[(2.61±0.78)d],and blood amylase recovery time[(3.33±0.39)d]were significantly less than the control group[(2.44±0.91)d,(5.42±0.45)d,(5.51±1.01)d,(6.12±0.97)d],the difference was statistically significant(P<0.05).The two groups of patients with APTT and PT were significantly decreased after treatment,and the APTT and PT in the study group for 7 days were significantly lower than those of the control group,the difference was statistically significant(P<0.05).There was no significant difference in adverse reactions between the study group and the control group(P>0.05).Conclusion The combined use of somatostatin and pantoprazole is effective in the treatment of severe pancreatitis,effectively improving the pH environment of the gastrointestinal tract,strengthening the inhibition of trypsin secretion,and significantly decreasing the level of sTREM-1 and urinary CAPAP in t

关 键 词：生长抑素 泮托拉唑 重型急性胰腺炎 尿液羧肽酶B激活肽 血清可溶性髓系细胞触发受体-1 

分 类 号：R576[医药卫生—消化系统]