乌司他丁、生长抑素联合在急性胰腺炎中的应用价值及对肠黏膜屏障功能的影响  

Effect of ulinastatin combined with half dose somatostatin on acute pancreatitis and intestinal mucosal barrier function

作　　者：朱理珂 黄鹏 梁晴晴 ZHU Like;HUANG Peng;LIANG Qingqing(Department of Gastroenterology,Shenhuo Group General Hospital,Shangqiu,Henan 476600,China)

机构地区：[1]河南神火集团总医院消化内科,河南商丘476600

出　　处：《中国医学工程》2023年第8期120-124,共5页China Medical Engineering

摘　　要：目的分析乌司他丁联合半剂量生长抑素治疗急性胰腺炎的有效性及对患者肠黏膜屏障的影响。方法选取河南神火集团总医院2020年2月至2021年2月收治的急性胰腺炎患者88例,盲法分为对照组、观察组,给予对照组患者乌司他丁联合标准剂量生长抑素治疗,观察组在对照组的基础上联合半剂量生长抑素治疗。对比两组症状改善指标、肠黏膜屏障功能指标(内毒素、D-乳酸、二胺氧化酶)、炎症相关细胞因子(超敏C反应蛋白、白细胞介素-6、单核细胞趋化蛋白-1)、氧化应激指标(超氧化物歧化酶、丙二醛)水平和治疗有效率。结果两组性别、年龄、急性生理与慢性健康状况评分(APACHEⅡ)、疾病严重程度差异均无统计学意义(P>0.05)。与对照组比较,观察组白细胞计数恢复正常时间、肠功能恢复正常时间、腹痛缓解时间和住院时间均较短(P<0.05)。治疗前,两组内毒素、D-乳酸、二胺氧化酶差异无统计学意义(P>0.05)。治疗后,两组内毒素、D-乳酸、二胺氧化酶水平均降低;与对照组比较,观察组内毒素、D-乳酸、二胺氧化酶水平较低(P<0.05)。治疗前,两组超敏C反应蛋白、白细胞介素-6、单核细胞趋化蛋白-1差异无统计学意义(P>0.05)。治疗后,两组超敏C反应蛋白、白细胞介素-6、单核细胞趋化蛋白-1水平均降低;与对照组比较,观察组超敏C反应蛋白、白细胞介素-6、单核细胞趋化蛋白-1水平较低(P<0.05)。治疗前,两组患者超氧化物歧化酶、丙二醛水平差异无统计学意义(P>0.05)。治疗后,两组超氧化物歧化酶水平升高,丙二醛水平降低;与对照组比较,观察组超氧化物歧化酶水平较高,丙二醛水平较低(P<0.05)。观察组总有效率(93.2%)高于对照组(77.3%)(P<0.05)。结论乌司他丁联合半剂量生长抑素可有效提升急性胰腺炎临床疗效,改善患者肠黏膜屏障功能,抑制机体炎症扩散,帮助促进疾病预后转归【Objective】To analyze the clinical effect of ulinastatin combined with half dose somatostatin on patients with acute pancreatitis and its influence on intestinal mucosal barrier.【Methods】Eighty-eight patients with acute pancreatitis admitted to Henan Shenhuo Group General Hospital from February 2020 to February 2021 were selected.They were blindly divided into the control group and the observation group.The patients in the control group were given conventional symptomatic treatment and simple ulinastatin treatment.The observation group was given half dose somatostatin combined treatment on the basis of the control group.The symptom improvement,intestinal mucosal barrier function indicators[endotoxin,D-lactic acid,diamine oxidase(DAO)],inflammatory cytokines[high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),monocyte chemoattractant protein-1(MCP-1)],oxidative stress indicators[superoxide dismutase(SOD),malondialdehyde(MDA)]and treatment efficiency of the two groups were compared.【Results】There was no significant difference in gender,age,Acute Physiology and Chronic Health Evaluation II(APACHE II)score and disease severity between the two groups(all P>0.05).Compared with the control group,the time for white blood cell count to return to normal,the time for intestinal function to return to normal,the time for abdominal pain relief and the hospital stay in the observation group were shorter,with statistically significant differences(all P<0.05).Before treatment,there was no significant difference in endotoxin,D-lactic acid and DAO between the two groups(P>0.05).After treatment,the levels of endotoxin,D-lactic acid and DAO decreased in both groups;compared with the control group,the levels of endotoxin,D-lactic acid and DAO in the observation group were lower,and the difference was statistically significant(all P<0.05).Before treatment,there was no significant difference between the two groups in the levels of hs-CRP,IL-6 and MCP-1(all P>0.05).After treatment,the levels of hs-CRP,IL-6 and MCP

关 键 词：急性胰腺炎 乌司他丁 半剂量生长抑素 肠黏膜屏障功能 

分 类 号：R657.51[医药卫生—外科学]