生长抑素治疗对胆道感染致脓毒症患者免疫功能、肠功能及预后转归的影响  

Effect of somatostatin therapy on immune function,intestinal function and prognosis of patients with sepsis caused by biliary tract infection

作　　者：徐鑫[1] 郑高明[2] 武伟[1] 柴立新 朱全力 李杭[1] XU Xin;ZHENG Gaoming;WU Wei;CHAI Lixin;ZHU Quanli;LI Hang(Department of Gastrointestinal,Hepatobiliary,Spleen and Pancreatic Surgery,Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,China;Department of Laboratory Medicine,Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,China)

机构地区：[1]杭州师范大学附属医院胃肠肝胆脾胰外科,浙江杭州310015 [2]杭州师范大学附属医院检验科,浙江杭州310015

出　　处：《中国现代医生》2021年第22期123-127,共5页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2019KY130);浙江省杭州市农业与社会发展计划(20191203B99)。

摘　　要：目的探讨生长抑素治疗对胆道感染致脓毒症患者免疫功能、肠功能及预后转归的影响。方法选取2019年7月至2020年11月我院收治的84例胆道感染致脓毒症患者,按随机数字表法分为基础治疗组和生长抑素组,各42例。基础治疗组给予常规治疗,生长抑素组在基础治疗的基础上加用生长抑素。比较两组肠屏障功能、免疫功能以及预后转归情况。结果入院时、入院后第1天,两组D乳酸、二胺氧化酶、内毒素、降钙素原水平,差异无统计学意义(P>0.05);入院后第1天,生长抑素组内毒素水平明显低于入院时(P<0.05);入院后第2天、第3天、第7天,两组D乳酸、二胺氧化酶、内毒素、降钙素原水平明显低于入院时(P<0.05),且生长抑素组明显低于基础治疗组(P<0.05);治疗后,两组CD4^(+)/CD8^(+)、免疫球蛋白G、免疫球蛋白M水平明显高于治疗前(P<0.05),且生长抑素组明显高于基础治疗组(P<0.05);治疗后,两组序贯器官衰竭估计评分、急性生理学及慢性健康状况评分明显低于治疗前(P<0.05),且生长抑素组明显低于基础治疗组(P<0.05);生长抑素组重症监护室住院时间明显短于基础治疗组(P<0.05),两组28 d死亡率比较,差异无统计学意义(P>0.05)。结论生长抑素可有效改善胆道感染致脓毒症患者肠屏障功能及免疫功能,促进预后转归。Objective To investigate the effect of somatostatin therapy on immune function,intestinal function and prognosis of patients with sepsis caused by biliary tract infection.Methods A total of 84 patients with sepsis caused by biliary tract infection treated in our hospital from July 2019 to November 2020 were selected and divided into the basic treatment group and the somatostatin group using random number table method,with 42 patients in each group.The basic treatment group were given conventional treatment,and the somatostatin group were given somatostatin in addition to the basic treatment.The intestinal barrier function,immune function and prognosis of the two groups were compared.Results There were no significant differences in the levels of D lactic acid,diamine oxidase,endotoxin and procalcitonin between the two groups on admission and at 1 day after admission(P>0.05).At 1 day after admission,the level of endotoxin in the somatostatin group was significantly lower than that at admission(P<0.05).At 2,3 and 7 days after admission,the levels of D lactic acid,diamine oxidase,endotoxin and procalcitonin in the two groups were significantly lower than those at admission(P<0.05),and those in the somatostatin group were significantly lower than those in the basic treatment group(P<0.05).After treatment,the levels of CD4^(+)/CD8^(+),immunoglobulin G and immunoglobulin M in the two groups were significantly higher than those before treatment(P<0.05),and those in the somatostatin group were significantly higher than those in the basic treatment group(P<0.05).After treatment,the estimated scores of sequential organ failure,and acute physiology and chronic health status scores of the two groups were significantly lower than those before treatment(P<0.05),and those in the somatostatin group were significantly lower than those in the basic treatment group(P<0.05).The hospital stay in the intensive care unit of the somatostatin group was significantly shorter than that of the basic treatment group(P<0.05).There was no signi

关 键 词：生长抑素 胆道感染致脓毒症 肠屏障功能 免疫功能 预后转归 

分 类 号：R656.7[医药卫生—外科学]