丙氨酰谷氨酰胺联合奥曲肽+乌司他丁对重症急性胰腺炎患者BISAP评分、YKL-40和炎症因子的影响  

Effects of alanyl-glutamine combined with octreotide and ulinastatin on BISAP score, YKL-40, and inflammatory factors in patients with severe acute pancreatitis

作　　者：崔贵医 张隆陶[1] 王劲[1] Cui Guiyi;Zhang Longtao;Wang Jin(Department of Hepatobiliary Pancreatic Hernia,Jiaozuo People's Hospital,Jiaozuo 454000,China)

机构地区：[1]焦作市人民医院肝胆胰疝外科,河南焦作454000

出　　处：《华北理工大学学报（医学版）》2024年第3期222-227,共6页Journal of North China University of Science and Technology：Health Sciences Edition

摘　　要：目的 评价予以重症急性胰腺炎患者丙氨酰谷氨酰胺+奥曲肽+乌司他丁对血清甲壳质酶蛋白(YKL-40)、急性胰腺炎严重程度指数评分(BISAP)和炎症因子的影响。方法 以奇偶法将本院在2020年9月~2022年9月期间收治的64例重症急性胰腺炎患者分成观察组和对照组,每组各32例。观察组患者采取丙氨酰谷氨酰胺+奥曲肽+乌司他丁治疗,对照组患者采取奥曲肽+乌司他丁治疗,比较两组间临床疗效、炎症因子水平、BISAP评分及YKL-40水平、微循环、氧化应激、不良反应。结果 (1)观察组临床总有效率较对照组高(P<0.05);(2)观察组C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、白介素-8(IL-8)水平较对照组显著降低(P<0.05);(3)观察组治疗后BISAP评分、YKL-40水平较对照组低(P<0.05);(4)观察组灌注血管密度(PVD)、灌注血管比例(PPV)、微血管流动指数(MFI)水平均较对照组高(P<0.05);(5)观察组超氧化物歧化酶(SOD)水平较对照组高,丙二醛(MDA)、活性氧(ROS)水平较对照组低(P<0.05);(6)两组不良反应发生率比较差异无统计学意义(P>0.05)。结论 在重症急性胰腺炎的治疗中,丙氨酰谷氨酰胺+奥曲肽+乌司他丁疗效及安全性均较为理想,可促进患者微循环及氧化应激指标改善,对减轻疾病损害具有重要意义,值得推广。Objective To evaluate the effects of alanyl-glutamine combined with octreotide and ulinastatin on serum chitinase-3-like protein 1(YKL-40),Bedside Index for Severity in Acute Pancreatitis(BISAP)score,and inflammatory factors in patients with severe acute pancreatitis.Methods A total of 64 patients with severe acute pancreatitis admitted to our hospital from September 2020 to September 2022 were divided into an observation group and a control group using the even-odd method,with 32 patients in each group.The observation group was treated with alanyl-glutamine combined with octreotide and ulinastatin,while the control group was treated with octreotide and ulinastatin.The clinical efficacy,inflammatory factor levels,BISAP score,YKL-40 level,microcirculation,oxidative stress,and adverse reactions were compared between the two groups.Results(1)The clinical total effective rate in the observation group was higher than that in the control group(P<0.05);(2)The levels of C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),and interleukin-8(IL-8)in the observation group were significantly lower than those in the control group(P<0.05);(3)The BISAP score and YKL-40 level in the observation group after treatment were lower than those in the control group(P<0.05);(4)The perfusion vessel density(PVD),perfusion vessel proportion(PPV),and microvascular flow index(MFI)levels in the observation group were higher than those in the control group(P<0.05);(5)The superoxide dismutase(SOD)level in the observation group was higher than that in the control group,while the malondialdehyde(MDA)and reactive oxygen species(ROS)levels were lower than those in the control group(P<0.05);(6)There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion In the treatment of severe acute pancreatitis,alanyl-glutamine combined with octreotide and ulinastatin shows ideal efficacy and safety,promoting the improvement of microcirculation and oxidative stress indicators,and is o

关 键 词：丙氨酰谷氨酰胺 奥曲肽 乌司他丁 重症急性胰腺炎 BISAP评分 YKL-40 炎症因子 

分 类 号：R576[医药卫生—消化系统]