乌司他丁联合奥曲肽对急性胰腺炎患者炎症水平及肠粘膜屏障功能的影响  

Effect of Ulinastatin Combined with Octreotide on Inflammatory Level and Intestinal Mucosal Barrier Function in Patients with Acute Pancreatitis

作　　者：朱艳平[1] 司琳琳 ZHU Yanping;SI Linlin(Department of Gastroenterology,Shenqiu County Traditional Chinese Medicine Hospital,Zhoukou Henan 466300,China;Department of Gastroenterology,Zhengzhou People’s Hospital,Zhengzhou Henan 450000,China)

机构地区：[1]沈丘县中医院脾胃科,河南周口466300 [2]郑州人民医院消化内科,河南郑州450000

出　　处：《临床研究》2023年第5期92-96,共5页Clinical Research

摘　　要：目的探讨乌司他丁联合奥曲肽治疗急性胰腺炎(AP)的临床疗效以及对患者炎症水平及肠粘膜屏障功能的影响。方法采用随机数表法将沈丘县中医院2018年1月至2020年12月收治的112例AP患者分为对照组(56例,仅采取奥曲肽治疗)和观察组(56例,在对照组基础上联合乌司他丁治疗)。两组均持续治疗7 d。比较两组临床疗效、治疗基本情况、炎性指标[C反应蛋白(CRP)、白介素-1β(IL-1β)、单核细胞趋化蛋白(MCP-1)、白介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)]、肠粘膜屏障功能指标、T淋巴细胞和并发症发生情况。结果观察组治疗有效率高于对照组,差异有统计学意义(P<0.05)。观察组腹痛、腹胀缓解、首次排便、肠鸣音恢复及住院等时间均短于对照组,差异有统计学意义(P<0.05)。两组治疗前患者炎症指标、淀粉酶水平对比,差异无统计学意义(P>0.05);治疗7 d后,两组患者炎症指标、淀粉酶水平均优于治疗前,且观察组血清CRP、IL-1β、IL-8、MCP-1、TNF-α及淀粉酶水平均低于对照组,差异有统计学意义(P<0.05);两组治疗前患者肠粘膜屏障功能指标比,差异无统计学意义(P>0.05);治疗7 d后,两组患者肠粘膜屏障功能指标均优于治疗前,且观察组血清二胺氧化酶、内毒素及D-乳糖水平均低于对照组(P<0.05)。两组治疗前患者T淋巴细胞指标比较,差异无统计学意义(P>0.05);治疗7 d后,两组患者T淋巴细胞指标均优于治疗前,且观察组CD3、CD4高于对照组,CD8水平低于对照组,差异无统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论乌司他丁联合奥曲肽治疗急性胰腺炎临床疗效确切,优于单一使用奥曲肽治疗,可改善患者炎症、淀粉酶水平及肠粘膜屏障功能,促进患者早日康复。Objective To investigate the clinical efficacy of ulinastatin combined with octreotide in the treatment of acute pancreatitis(AP)and its effect on the level of inflammation and intestinal mucosal barrier function of patients.Methods A total of 112 patients with AP admitted to Shenqiu County Hospital of Traditional Chinese Medicine from January 2018 to December 2020 were divided into control group(56 cases,treated with octreotide only)and observation group(56 cases,treated with ulinastatin on the basis of control group)by random number table method.Both groups were treated continuously for 7 days.Compare the clinical efficacy,basic treatment information,and inflammatory indicators of C-reactive protein(CRP)and interleukin-1 between two groupsβ(IL-1β),Monocyte chemotactic protein(MCP-1),interleukin-8(IL-8),and tumor necrosis factor-α(TNF-α),Functional indicators of intestinal mucosal barrier,T lymphocytes,and incidence of complications.Results The total effective rate of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05);The observation group had shorter time for abdominal pain,relief of bloating,first bowel movement,recovery of bowel sounds,and hospitalization compared to the control group,with statistically significant differences(P<0.05);There was no statistically significant difference in inflammation indicators and amylase levels between the two groups of patients before treatment(P>0.05);After 7 days of treatment,the inflammatory indicators and amylase levels in both groups of patients were better than before treatment,moreover,the serum levels of CRP,IL-1β,IL-8,MCP-1,TNF-αand amylase in the observation group were all lower than those in the control group,showing statistically significant differences(P<0.05);There was no statistically significant difference in the intestinal mucosal barrier function indicators between the two groups of patients before treatment(P>0.05);After 7 days of treatment,the intestinal mucosal barrier function indi

关 键 词：急性胰腺炎 奥曲肽 乌司他丁 炎症水平 肠粘膜屏障功能 

分 类 号：R576[医药卫生—消化系统]