丙氨酰谷氨酰胺联合奥曲肽治疗急性胰腺炎相关性肺损伤的疗效  

Efficacy of alanyl glutamine combined with octreotide in the treatment of acute pancreatitis associated lung injury

作　　者：邵宏华[1] 朱亮 李莎 陈巧巧[1] SHAO Honghua;ZHU Liang;LI Sha;CHEN Qiaoqiao(Department of Pharmacy,Jinhua Municipal Central Hospital,Jinhua 321000,Zhejiang,China;Dispensary of Traditional Chinese Medicine,Jinhua Municipal Central Hospital,Jinhua 321000,Zhejiang,China)

机构地区：[1]金华市中心医院药学部,浙江金华321000 [2]金华市中心医院中药房,浙江金华321000

出　　处：《中国现代医生》2025年第7期67-70,共4页China Modern Doctor

摘　　要：目的探讨丙氨酰谷氨酰胺联合奥曲肽治疗急性胰腺炎(acute pancreatitis,AP)相关性肺损伤的疗效。方法选取2022年6月至2024年6月金华市中心医院收治的AP相关性肺损伤患者94例,根据随机数字表法将患者分为观察组和对照组,每组47例。对照组患者给予奥曲肽治疗,观察组患者在对照组基础上给予丙氨酰谷氨酰胺治疗。比较两组患者的疗效、Balthazar CT分级、急性生理学和慢性健康状况评价Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)评分、Murray肺损伤评分(Murray lung injury score,MLIS)、Toll样受体4(Toll-like receptor 4,TLR4)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)和血气指标[动脉血氧分压(arterial partial pressure of oxygen,PaO_(2))、动脉血氧饱和度(arterial oxygen saturation,SaO_(2))和氧合指数]。结果观察组患者的疗效显著优于对照组(χ^(2)=5.817,P=0.016)。治疗后,两组患者的Balthazar CT分级、APACHEⅡ评分、MLIS评分、TLR4、MMP-9均显著低于本组治疗前,PaO_(2)、SaO_(2)、氧合指数均显著高于本组治疗前(P<0.05),观察组患者的Balthazar CT分级、APACHEⅡ评分、MLIS评分、TLR4、MMP-9均显著低于对照组,PaO_(2)、SaO_(2)、氧合指数均显著高于对照组(P<0.05)。结论丙氨酰谷氨酰胺联合奥曲肽治疗AP相关性肺损伤的效果显著,可改善患者的临床症状,减轻肺损伤和炎症反应。Objective To investigate the efficacy of alanyl glutamine combined with octreotide in the treatment of acute pancreatitis(AP)associated lung injury.Methods A total of 94 patients with AP associated lung injury admitted to Jinhua Municipal Central Hospital from June 2022 to June 2024 were selected and divided into observation group and control group according to random number table method,with 47 patients in each group.Patients in control group were treated with octreotide,patients in observation group were treated with alanyl glutamine on the basis of control group.The efficacy,Balthazar CT grading,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,Murray lung injury score(MLIS),Toll-like receptor 4(TLR4),matrix metalloproteinase-9(MMP-9)and blood gas indexes[arterial partial pressure of oxygen(PaO_(2)),arterial oxygen saturation(SaO_(2))and oxygenation index]were compared between two groups.Results The curative effect of observation group was significantly better than that of control group(χ^(2)=5.817,P=0.016).After treatment,the Balthazar CT grading,APACHEⅡscore,MLIS score,TLR4 and MMP-9 of patients in two groups were significantly lower than before treatment,while PaO_(2),SaO_(2)and oxygenation index were significantly higher than before treatment(P<0.05).Balthazar CT grading,APACHEⅡscore,MLIS score,TLR4 and MMP-9 in observation group were significantly lower than those in control group,while PaO_(2),SaO_(2)and oxygenation index were significantly higher than those in control group(P<0.05).Conclusion Alanyl glutamine combined with octreotide has a significant effect in the treatment of patients with AP associated lung injury,which can improve the clinical symptoms of patients,reduce lung injury and inflammation.

关 键 词：丙氨酰谷氨酰胺 奥曲肽 急性胰腺炎 肺损伤 TOLL样受体4 基质金属蛋白酶-9 

分 类 号：R657.51[医药卫生—外科学]