内镜下止血治疗联合奥曲肽对十二指肠溃疡伴出血患者的治疗效果及免疫功能影响  

Effects of endoscopic hemostasis combined with octreotide on immune function in patients with peptic ulcer bleeding

作　　者：莫霏霏 余光[1] 金玲玲 章月桃 王国祥[1] MO Feifei;YU Guang;JIN Lingling;ZHANG Yuetao;WANG Guoxiang(Department of Gastroenterology,Taizhou Municipal Hospital,Zhejiang,Taizhou 318000,China;Functional Diagnostic Center,Taizhou Central Hospital(Taizhou University Hospital),Zhejiang,Taizhou 318000,China)

机构地区：[1]台州市立医院消化内科,浙江台州318000 [2]台州市中心医院(台州学院附属医院)功能诊断中心,浙江台州318000

出　　处：《中国现代医生》2022年第32期34-38,共5页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2018KY908)。

摘　　要：目的探究内镜下止血治疗联合奥曲肽对十二指肠溃疡伴出血患者的治疗效果及免疫功能的影响。方法选取2018年4月至2020年4月台州市立医院收治的十二指肠溃疡伴出血患者140例,采用随机数字表法分为对照组和联合组,每组各70例。对照组患者在常规治疗的基础上使用奥曲肽进行治疗,联合组在对照组的基础上给予内镜下止血进行治疗。观察两组患者平均输血量及平均住院时间;使用ATP比色法检测氢–钾–ATP酶(hydrogen+–kalium+–ATPase,H+–K+–ATPase)活性、促胃液素,采用免疫透射比浊法检测基础胃酸分泌量(basal acid output,BAO)、单胺氧化酶(monoamine oxidase,MAO)、铜绿假单胞菌(Pseudomonas aeruginosa,PAO),采用酶联免疫吸附法检测肿瘤坏死因子–α(tumor necrosis factor–α,TNF–α)、超敏C反应蛋白(high–sensitivity C–reactive protein,hs–CRP),采用流式细胞仪检测T淋巴细胞亚群(CD3+、CD4+、CD8+)。观察两组患者手术止血状况、止血成功率以及再出血情况。结果与对照组相比,联合组患者的H+–K+–ATP酶活性、促胃液素、BAO、MAO、PAO、TNF–α、hs–CRP、CD8+显著下降,差异无统计学意义(P>0.05),CD3+、CD4+上升,差异有统计学意义(P<0.05)。联合组的平均输血量、再出血情况均少于对照组,差异均有统计学意义(P<0.05);联合组的止血成功率和再出血发生率大于对照组,差异有统计学意义(P<0.05)。结论使用内镜下止血治疗联合奥曲肽对十二指肠溃疡伴出血患者进行治疗,能够降低患者体内H+–K+–ATP酶活性、胃泌素,调节TNF–α、hs–CRP、CD3+、CD4+、CD8+,减少患者平均输血量、住院时间以及再出血情况,对十二指肠溃疡伴出血患者起到一定的治疗作用,增强患者的免疫功能。Objective To explore the therapeutic effect of endoscopic hemostasis combined with octreotide on patients with duodenal ulcer with bleeding.Methods A total of 140 patients with duodenal ulcer with bleeding who were treated in Taizhou Municipal Hospital from April 2018 to April 2020 were selected and randomly divided into the control group and the combined group with 70 cases in each group.The control group was given routine treatment on basis of octreotide was used for treatment,and the combination group was given endoscopic hemostasis treatment on basis of the control group.The average blood transfusion volume and average hospital stay of the two groups were observed.ATP colorimetry was used to detect the activity of hydrogen–potassium–ATPase(H+–K+–ATPase)enzyme activity,gastrin,and immunoturbidimetry was used to detection of basal acid output(BAO),monoamine oxidase(MAO),Pseudomonas aeruginosa(PAO),using enzyme–linked immunosorbent assay to detect tumor necrosis factor–α(TNF–α),high–sensitivity C–reactive protein(hs–CRP),and T lymphocyte subsets(CD3+,CD4+,CD8+)were detected by flow cytometry.The surgical hemostasis,hemostasis success rate,and rebleeding were observed in the two groups.Results Compared with the control group,patients in the combined group showed a significant decrease in H+-K+-ATPase activity,gastrin,BAO,MAO,PAO,TNF-α,hs-CRP,CD8+,with no statistically significant difference(P>0.05),and an increase in CD3+and CD4+,with a statistically significant difference(P<0.05).The mean blood transfusion and rebleeding in the combined group were all less than those of the control group,and the differences were statistically significant(P<0.05),and the rate of successful haemostasis and the incidence of re-bleeding in the combined group was greater than those in the control group,with a statistically significant difference(P<0.05).Conclusion The use of endoscopic hemostasis therapy combined with octreotide in patients with duodenal ulcer with bleeding can reduce H+-K+-ATP enzyme activity,

关 键 词：止血治疗 十二指肠溃疡伴出血 奥曲肽 内镜 免疫功能 

分 类 号：R574.1[医药卫生—消化系统]