奥曲肽与乌司他汀联合治疗急性重症胰腺炎的效果及机制

发布时间：2018-06-30 05:35

本文选题：急性重症胰腺炎 + 奥曲肽　；参考：《山东医药》2016年41期

【摘要】：目的观察奥曲肽与乌司他汀联合治疗急性重症胰腺炎的效果并探讨其机制。方法选取急性重症胰腺炎患者112例,随机分为观察组与对照组各56例,对照组给予奥曲肽治疗,25μg/h持续泵入,0.6 mg/d;观察组在此基础上加用乌司他汀,将乌司他汀10万U溶于500 m L的5%葡萄糖溶液中静脉滴注,2次/d。10 d后比较两组治疗效果,采用ELISA法检测血清IL-6、TNF-α,采用酶化学法检测血淀粉酶,采用碘-淀粉比色法测定尿淀粉酶,采用日立7600型全自动生化分析仪检测血清C反应蛋白。结果观察组治愈30例,显效12例,有效8例,无效6例,总有效率89.3%;对照组分别为18、12、14、12例,78.6%,两组总有效率比较,P均0.05。观察组与对照组血清IL-6水平分别为(29.0±4.2)、(45.7±5.3)ng/L,TNF-α水平分别为(18.9±3.5)、(25.2±3.2)ng/L,两组比较,P均0.05。观察组与对照组血蛋白酶水平分别为(0.2±0.1)、(0.7±0.3)×10~3U/L,尿蛋白酶水平分别为(0.3±0.2)、(0.7±0.2)×10~3U/L,C反应蛋白水平分别为(45.2±6.7)、(46.5±7.1)×103U/L,两组比较,P均0.05。结论奥曲肽与乌司他汀联合治疗急性重症胰腺炎的效果优于奥曲肽单用,其机制可能与降低炎症性细胞因子水平有关。
[Abstract]:Objective to observe the effect and mechanism of octreotide combined with ulinastatin in the treatment of severe acute pancreatitis. Methods 112 patients with severe acute pancreatitis were randomly divided into observation group (n = 56) and control group (n = 56). After intravenous infusion of Ulinastatin 100000 U in 500ml 5% glucose solution for 2 times per day, the therapeutic effects were compared between the two groups. Serum IL-6 TNF- 伪 was detected by Elisa, serum amylase was detected by enzyme chemistry, and urine amylase was determined by iodine-starch colorimetry. Serum C-reactive protein (CRP) was detected by Hitachi 7600 automatic biochemical analyzer. Results in the observation group, 30 cases were cured, 12 cases were markedly effective, 8 cases were effective, 6 cases were ineffective, and the total effective rate was 89.3.The total effective rate in the control group was 1812 / 1412 / 78.6.The total effective rate of the two groups was 0.05 respectively. The serum IL-6 levels in the observation group and the control group were (29.0 卤4.2), (, 45.7 卤5.3) ng / L and (18.9 卤3.5), (, 25.2 卤3.2) ng / L, respectively (P 0.05). The levels of blood protease and urine protease were (0.2 卤0.1), (卤0.7 卤0.3) 脳 10 ~ (-3) U / L and (0.3 卤0.2), (卤0.7 卤0.2) 脳 10 ~ (-3) U / L respectively in the observation group and the control group, respectively (45.2 卤6.7), (46.5 卤7.1) 脳 10 ~ (3) U / L, respectively (P < 0.05). Conclusion Octreotide combined with ulinastatin is more effective than octreotide alone in the treatment of severe acute pancreatitis, and its mechanism may be related to the reduction of inflammatory cytokines.
【作者单位】：石河子大学医学院第一附属医院;
【分类号】：R576

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