连续性血液净化联合甲磺酸加贝酯对重症急性胰腺炎的治疗效果及作用机制

发布时间：2018-05-01 00:09

本文选题：重症急性胰腺炎 + 甲磺酸加贝酯　；参考：《山东医药》2017年48期

【摘要】：目的探讨连续性血液净化联合甲磺酸加贝酯治疗重症急性胰腺炎(SAP)的临床效果及作用机制。方法选取SAP患者62例,随机分为观察组和对照组各31例。两组均给予常规处理及连续性血液净化,观察组再静滴甲磺酸加贝酯,两组均连续治疗5天。疗程结束时统计两组临床症状缓解时间,评价临床疗效,采用ELISA法检测治疗前后血清淀粉酶(AMY)、细胞间黏附分子1(ICAM-1)及二胺氧化酶(DAO)、D-乳酸,统计治疗期间两组不良反应发生率。结果观察组恶心、呕吐、腹胀、腹痛、发热缓解时间均较对照组缩短(P均0.05)。观察组总有效率93.55%,高于对照组的70.97%(P0.05)。两组治疗后血清AMY、ICAM-1及DAO、D-乳酸水平均较治疗前降低(P均0.01),且观察组降低更显著(P均0.05)。治疗期间观察组不良反应发生率为19.35%,对照组为12.90%,两组比较P0.05。结论连续性血液净化联合甲磺酸加贝酯治疗SAP效果优于单独连续性血液净化;抑制炎症反应、改善肠黏膜功能可能是其作用机制。
[Abstract]:Objective to investigate the clinical effect and mechanism of continuous blood purification combined with gabelle mesylate in the treatment of severe acute pancreatitis (SAP). Methods Sixty-two patients with SAP were randomly divided into observation group (n = 31) and control group (n = 31). Both groups were given routine treatment and continuous blood purification. At the end of the course of treatment, the remission time of clinical symptoms was counted and the clinical efficacy was evaluated. Before and after treatment, the levels of serum amylase, intercellular adhesion molecule 1 (ICAM-1) and diamine oxidase (DAOOX D- lactic acid) were measured by ELISA method. The incidence of adverse reactions in the two groups was counted during the treatment. Results the time of nausea, vomiting, abdominal distension, abdominal pain and fever in the observation group was significantly shorter than that in the control group (P < 0.05). The total effective rate of the observation group was 93.555.It was higher than that of the control group (70.97g / kg). After treatment, the levels of serum AMYT ICAM-1 and DAOX D- lactic acid in both groups were lower than those before treatment (P < 0.01), and those in the observation group were significantly lower than those in the control group (P < 0.05). The incidence of adverse reactions was 19.35 in the observation group and 12.90 in the control group (P 0.05). Conclusion the effect of continuous blood purification combined with gabelle mesylate on SAP is better than that of continuous blood purification alone, and inhibition of inflammatory reaction and improvement of intestinal mucosal function may be its mechanism.
【作者单位】：海南医学院第二附属医院东湖分院;海南医学院第一附属医院;
【基金】：海南省卫生计生行业科研项目(14A210207)
【分类号】：R576

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