香丹注射液联合乌司他丁治疗重症急性胰腺炎的疗效及对血液流变学和血清SOD、CRP、IL-6水平的影响  

Effect of Xiangdan injection combined with Ulinastatin on severe acute pancreatitis and its influence on the levels of SOD, CRP and IL-6 in serum and hemorheology

作　　者：余琳 武晓灵[1] YU Lin;WU Xiaoling(Department of Critical Care,Wuhan Central Hospital,Wuhan,430014,China)

机构地区：[1]华中科技大学同济医学院附属武汉市中心医院重症医学科,武汉430014

出　　处：《中国中西医结合消化杂志》2021年第6期421-425,共5页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

摘　　要：目的:探讨香丹注射液联合乌司他丁治疗重症急性胰腺炎(SAP)的临床疗效以及其对患者血液流变学和血清超氧化物歧化酶(SOD)、C反应蛋白(CRP)、IL-6水平的影响。方法:选取2018年3月-2020年3月我院收治的90例SAP患者为研究对象,采用随机数字表法将其分为观察组(n=45)与对照组(n=45)。其中对照组予以注射用乌司他丁静脉滴注治疗,观察组在此基础上联合香丹注射液治疗。连续治疗7 d后评估并比较2组疗效和安全性。记录2组受试者腹痛消失时间、肠鸣音恢复时间、重症监护室(ICU)住院时间及治疗前后急性生理和慢性健康状况评分Ⅱ(APACHEⅡ)评分、血液流变学参数[全血黏度高切、低切(WHV和WLV),血浆黏度(PV),红细胞聚集指数(EAI)]和血清SOD、CRP、IL-6水平的变化情况,并进行统计分析。结果:观察组总有效率[93.3%(42/45)]较对照组[77.8%(35/45)]显著提高(P<0.05)。观察组腹痛消失时间、肠鸣音恢复时间及ICU住院时间均显著短于对照组(P<0.05);2组治疗后APACHEⅡ评分均较同组治疗前显著下降(P<0.05),但观察组比对照组对APACHEⅡ评分的降低作用更显著(P<0.05)。2组治疗后WHV、WLV、PV及EAI均较同组治疗前显著下降(P<0.05),但观察组治疗后WHV、WLV、PV和EAI与对照组同期比较均降低更显著(P<0.05)。与同组治疗前比较,2组治疗后血清SOD水平均显著升高(P<0.05),血清CRP、IL-6水平均显著降低(P<0.05);且与对照组同期比较,观察组治疗后血清SOD水平显著更高(P<0.05),血清CRP、IL-6浓度均显著更低(P<0.05)。在不良反应率方面,观察组[11.1%(5/45)]与对照组[8.9%(4/45)]比较,差异无统计学意义。结论:应用香丹注射液联合乌司他丁治疗SAP的整体疗效满意,能进一步缓解患者病情,改善预后,其作用机制可能与其显著纠正血流变学异常和提高血清SOD及下调血清CRP、IL-6的表达水平有关。Objective: To investigate the clinical efficacy of Xiangdan injection combined with Ulinastatin in the treatment of severe acute pancreatitis and its effect on the levels of hemorheology and serum Superoxide dismutase, c-reactive protein(CRP) and interleukin-6(IL-6). Methods: Ninety patients with SAP admitted to our hospital from March 2018 to March 2020 were selected and randomly divided into Observation Group(n=45) and Control Group(n=45). The Control Group was injected with Ulinastatin intravenous drip treatment, the observation group on this basis combined Xiangdan injection treatment. The efficacy and safety of the two groups were evaluated and compared after 7 days of continuous treatment. The disappearance time of abdominal pain, the recovery time of bowel sounds, the time of intensive-care unit hospitalization, the score of acute physical and chronic health condition Ⅱ(APACHE Ⅱ), the hemorheology parameters[whole blood viscosity high shear, low shear(WHV and WLV) ]were recorded, the changes of plasma viscosity(PV), erythrocyte aggregation index(EAI) and serum levels of SOD, CRP and IL-6 were analyzed statistically. Results: The total effective rate[93.3%(42/45) ]of the observation group was significantly higher than that of the control group[77.8%(35/45) ](P<0.05). The observation group abdominal pain disappeared time, bowel sound recovery time and ICU stay time were significantly shorter than the control group(P<0.05), APACHE Ⅱ score was significantly lower in both groups after treatment than that before treatment(P<0.05), however, APACHE Ⅱ score in the observation group was significantly lower than that in the control group(P<0.05). After treatment, WHV, WLV, PV and EAI in the two groups were significantly lower than those before treatment(P<0.05), but after treatment, WHV, WLV, PV and EAI in the observation group were significantly lower than those in the control group(P<0.05). Compared with the control group before treatment, the levels of SOD in the two groups after treatment were significant

关 键 词：重症急性胰腺炎 香丹注射液 乌司他丁 血液流变学 氧化应激 炎性因子 

分 类 号：R576[医药卫生—消化系统]