乌司他丁联合奥曲肽治疗重症胰腺炎的临床疗效  

Clinical efficacy of ulinastatin combined with octreotide in treatment of severe pancreatitis

作　　者：吴凤霞[1] 王树俊[1] WU Feng-xia;WANG Shu-jun(Department of Gastroenterology,First People's Hospital of Zhengzhou,Zhengzhou 450000,Henan,China)

机构地区：[1]郑州市第一人民医院消化内科,河南郑州450000

出　　处：《中国校医》2022年第1期68-70,共3页Chinese Journal of School Doctor

摘　　要：目的探讨乌司他丁联合奥曲肽治疗重症胰腺炎临床疗效和免疫功能的变化。方法选取2018年8月—2020年8月本院收治的重症胰腺炎患者168例,根据随机数表法分为联合组和奥曲肽组各84例,奥曲肽组使用奥曲肽进行治疗,联合组患者在此基础上给予乌司他丁进行联合治疗,观察两组患者临床症状缓解情况,并对两组患者治疗前后炎性因子水平和免疫功能水平进行比较。结果联合组治疗总有效率为94.05%,高于对照组的85.71%,(χ^(2)=9.767,P=0.008)。联合组腹痛缓解时间为(3.28±0.29)d、腹胀消失时间为(2.38±0.46)d、发热消失时间为(4.54±0.53)d、血淀粉酶恢复时间为(5.14±0.69)d、尿淀粉酶恢复时间为(4.06±0.59)d、均少于奥曲肽组的(5.15±0.62)d、(5.13±0.72)d、(7.82±0.87)d、(7.19±0.91)d、(8.25±1.58)d,(t=25.040、29.499、29.509、16.452、22.769,P值均<0.01)。治疗前两组炎性因子水平指标差异无统计学意义(P>0.05);治疗后两组CRP、TNF-α和IL-6均降低,联合组各指标水平为(5.63±0.55)mg/L、(178.29±19.38) pg/mL、(31.41±3.24)pg/mL,低于奥曲肽组的(14.16±2.58)mg/L、(249.62±25.91)pg/mL、(54.73±6.38)pg/mL,(t=29.636、28.374、29.869,P值均<0.01)。治疗前两组炎性因子水平指标差异无统计学意义(P>0.05);治疗后两组IgA、IgG和IgM均升高,联合组IgG水平为(19.52±2.06)g/L,高于奥曲肽组的(15.73±1.51)g/L,(t=13.600,P<0.01)。结论乌司他丁联合奥曲肽治疗重症胰腺炎,可明显缓解患者临床症状,降低患者炎症情况,改善患者免疫功能水平,值得临床进一步推广。Objective To investigate the clinical efficacy and immune function of ulinastatin combined with octreotide in the treatment of severe pancreatitis.Methods A total of 168 patients with severe pancreatitis admitted to our hospital from August 2018 to August 2020 were selected and randomly divided into a combination group and an octreotide group with 84 cases in each group.The octreotide group was treated with octreotide,while the combination group was treated with ulinastatin on the basis of octreotide.The levels of inflammatory factors and immune function were investigated and compared between the two groups before and after the treatment.The clinical symptoms of the two groups were observed.The levels of inflammatory factors and immune function of the two groups before and after the treatment were compared.Results The total effective rate of the combination group(94.05%) was higher than that of the control group(85.71%),and the difference was statistically significant(χ^(2)=9.767,P=0.008).The remission time of abdominal pain,disappearance time of abdominal distension,disappearance time of fever,recovery time of blood amylase and recovery time of urine amylase in the combination group were(3.28±0.29) d,(2.38±0.46) d,(4.54±0.53) d,(5.14±0.69) d and(4.06±0.59) d respectively,which were less than those in the octreotide group [(5.15±0.62) d,(5.13±0.72) d,(7.82±0.87) d,(7.19±0.91) d and(8.25±1.58) d respectively,(t=25.040,29.499,29.509,16.452,22.769 respectively,all P <0.01)].There was no significant difference in inflammatory factors between the two groups before the treatment(P> 0.05);after the treatment,the levels of CRP,TNF-αand IL-6 decreased in both groups.In the combination group,the levels of CRP,TNF-α and IL-6 were(5.63±0.55) mg/L,(178.29±19.38) pg/ml,and(31.41±3.24) pg/ml respectively,which were lower than those in the octreotide group [(14.16±2.58) mg/L,(249.62±25.91) pg/ml,and(54.73±6.38) pg/ml respectively,(t= 29.636,28.374,29.869,P <0.01).Before the treatment,there were no significant

关 键 词：乌司他丁 奥曲肽 重症胰腺炎 临床疗效 安全性 

分 类 号：R453[医药卫生—治疗学] R576[医药卫生—临床医学]