连续性血液净化对重症胰腺炎患者的疗效及相关指标的影响  

Therapeutic Effect of Blood Purification and Its Influence on Related Indexes in Patients with Severe Pancreatitis

作　　者：武素珍[1] WU Suzhen(Affiliated Hospital of Inner Mongolia Medical University,Huhhot 010050,China)

机构地区：[1]内蒙古医科大学附属医院,内蒙古呼和浩特010050

出　　处：《北华大学学报（自然科学版）》2020年第5期630-633,共4页Journal of Beihua University（Natural Science）

基　　金：内蒙古自治区自然科学基金项目(2017MS0893);内蒙古医科大学科技百万工程联合项目(YKD2018KJBW(LH)092).

摘　　要：目的观察重症胰腺炎患者血液净化的临床疗效.方法选取重症急性胰腺炎患者128例,其中,观察组68例,对照组60例.对照组给予基础治疗,观察组加用连续性血液净化,记录患者临床指标改善情况.分别于治疗前、治疗后1、3、7 d应用酶联免疫吸附法测定外周血血管紧张素Ⅰ、血管紧张素Ⅱ、肾素、醛固酮及炎症因子水平.结果观察组患者恶心和腹痛症状、C反应蛋白、血清淀粉酶水平恢复正常所需时间明显短于对照组(P<0.05),观察组治疗总有效率明显高于对照组(P<0.01).治疗后两组患者血管紧张素、肾素、醛固酮明显低于治疗前(P<0.05);治疗后1、3 d,观察组血管紧张素、肾素、醛固酮明显低于对照组(P<0.05).治疗后两组患者C反应蛋白、IL-6、IL-8、TNF-α明显低于治疗前(P<0.05);治疗后1、3、7 d,观察组C反应蛋白、IL-6、IL-8明显低于对照组(P<0.05);治疗后1、3 d,观察组TNF-α明显低于对照组(P<0.05).结论连续性血液净化能够改善肾素-血管紧张素-醛固酮系统和炎症因子水平,明显缩短患者临床症状的恢复时间,提高临床疗效.Objective To investigate the therapeutic effect of blood purification in patients with severe pancreatitis.Method 128 patients with severe acute pancreatitis were randomly divided into observation group(68 cases)and control group(60 cases).The control group was given basic treatment,while the observation group was given continuous blood purification.The recovery time of clinical indexes and the effective rate of treatment were recorded.The levels of AngⅠ,AngⅡ,Renin,aldosterone,CRP,IL-6,IL-8 and TNF-αin peripheral blood were measured by enzyme-linked immunosorbent assay before 1,3 and 7 days after treatment.Results The time for nausea,abdominal pain,CRP and serum amylase level to return to normal in the observation group was significantly shorter than that in the control group(P<0.05).The total effective rate of the observation group was significantly higher than that of the control group(P<0.01).After treatment,the levels of Angiotension I,Angiotension II,renin and aldosterone in the two groups were significantly lower than those before treatment(P<0.05),and the levels of Angiotension I,Angiotension II,renin and aldosterone in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the levels of CRP,IL-6,IL-8 and TNF-αin the two groups were significantly lower than those before treatment(P<0.05);on the 1st,3rd and 7th day after treatment,the levels of CRP,IL-6 and IL-8 in the observation group were significantly lower than those in the control group(P<0.05);on the 1st and 3rd day after treatment,the levels of TNF-αin the observation group were significantly lower than those in the control group(P<0.05).Conclusion Continuous blood purification can significantly shorten the recovery time of symptoms,improve the clinical efficacy in patients with severe pancreatitis,improve renin-angiotension-aldosterone system and the level of inflammatory factors.

关 键 词：重症急性胰腺炎 血液净化 疗效 炎症因子 

分 类 号：R459.5[医药卫生—治疗学]