加贝酯联合生长抑素与奥美拉唑静脉滴注治疗老年重症胰腺炎患者的效果分析  

Effect of gabexate combined with somatostatin and omeprazole on proinflammatory cytokines in elderly patients with severe pancreatitis

作　　者：王慧[1] 符秀梅[1] 王素萍[1] 叶苗苗[2] Wang Hui;Fu Xiumei;Wang Suping(Department of Internal Medicine,Hainan Cadre Sanatorium(Hainan Geriatric Hospital),Haikou 571100,China)

机构地区：[1]海南省干部疗养院(海南省老年病医院)内科,海口571100 [2]海南省干部疗养院(海南省老年病医院)中医康复科,海口571100

出　　处：《中华保健医学杂志》2021年第1期35-38,共4页Chinese Journal of Health Care and Medicine

基　　金：海南省自然科学基金面上项目(817372)。

摘　　要：目的分析加贝酯联合生长抑素与奥美拉唑静脉滴注治疗老年重症胰腺炎患者的效果。方法前瞻性选择2017年5月~2019年5月海南省干部疗养院收治的120例老年重症胰腺炎患者,应用双色球法随机分为常规组和联合组,各60例。两组患者均给予抗感染、维持水和电解质平衡、止痛、胃肠减压、减少胰液及胃液的分泌等基础方式进行治疗,常规组加用生长抑素与奥美拉唑静脉滴注进行治疗,联合组患者在常规治疗基础上加用加贝酯进行治疗。比较分析两组患者治疗后的临床疗效、临床症状改善情况及不良反应发生情况,治疗前后的肠道黏膜屏障功能、胃肠激素和炎症因子水平。结果联合组患者的总有效率为98.33%,显著高于常规组的80.00%,差异具有统计学意义(P<0.05)。联合组患者的腹痛腹胀缓解时间、淀粉酶恢复时间、住院时间显著短于常规组,治疗后入院24 h内肛门排气率显著高于常规组,腹内高压显著低于常规组,差异具有统计学意义(P<0.05)。联合组患者治疗后D-乳酸和二胺氧化酶(DAO)水平、胃泌素(GAS)水平及肿瘤坏死因子-α(TNF-α)、白介素8(IL-8)和C反应蛋白(CRP)水平显著低于常规组;胃动素(MTL)水平显著高于常规组,差异具有统计学意义(P<0.05)。两组患者治疗过程中均未出现不良反应。结论应用加贝酯联合生长抑素与奥美拉唑静脉滴注治疗老年重症胰腺炎患者效果显著,明显改善患者的临床症状,降低炎症因子水平,改善肠道黏膜屏障功能和胃肠激素,且安全性较高。Objective To analyze the effect of gabeate combined with somatostatin and omeprazole intravenous infusion in the treatment of elderly patients with severe pancreatitis. Methods a total of 120 elderly patients with severe pancreatitis from May 2017 to may 2019 were randomly divided into two groups:conventional group and combined group.Two groups of patients were given anti infection,maintaining water and electrolyte balance,pain relief,gastrointestinal decompression,reducing the secretion of pancreatic juice and gastric juice and other basic treatment,conventional group was treated with somatostatin and omeprazole intravenous drip,combined group was treated with gabexate on the basis of conventional treatment.The clinical efficacy,improvement of clinical symptoms and adverse reactions,intestinal mucosal barrier function,gastrointestinal hormone and proinflammatory cytokines levels before and after treatment were compared and analyzed between the two groups. Results the total effective rate of the combined group was 98.33%,which was significantly higher than that of the conventional group(80.00%)(P < 0.05).The relief time of abdominal pain,abdominal distension,amylase recovery time and hospital stay time of patients in the combined group were significantly shorter than those in the conventional group. The anal exhaust rate within 24 h after admission was significantly higher than that of the conventional group,and the intra-abdominal hypertension was significantly lower than that of the conventional group,with statistically significant differences(P < 0.05).After treatment,the levels of D-lactate,DAO,GAS,TNF-α,IL-8 and CRP in the combined group were significantly lower than those in the conventional group,and the levels of MTL were significantly higher than those in the conventional group(P < 0.05).There were no adverse reactions in the two groups. Conclusion The efficacy of gabeate combined with somatostatin and omeprazole intravenous infusion in the treatment of elderly patients with severe pancreatitis is signi

关 键 词：生长抑素 奥美拉唑 老年重症胰腺炎 胃肠激素 炎症因子 

分 类 号：R576[医药卫生—消化系统]