大黄灌肠对重症急性胰腺炎患者血清高迁移率族蛋白B1、PCT、IL-6、TNF-α的影响

发布时间：2018-03-10 09:20

  本文选题：大黄　切入点：重症急性胰腺炎　出处：《重庆医科大学学报》2017年09期 　论文类型：期刊论文

【摘要】：目的:观察大黄灌肠对重症急性胰腺炎(severe acute pancreatitis,SAP)患者血清高迁移率族蛋白B1(high mobility group B1,HMGB1)、降钙素原(procalcitonin,PCT)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factorsα,TNF-α)及疾病预后的影响。方法:收集SAP患者60例,随机分为大黄治疗观察组组(大黄灌肠,30例)和常规治疗对照组(肥皂水灌肠,30例),分别在入院后第1、3、5天动态监测各组患者血清的HMGB1、PCT、IL-6与TNF-α浓度变化,并观察患者腹痛腹胀缓解时间、排气排便时间、CRRT时间及2组患者的治疗效果。结果:治疗当天2组患者HMGB1、PCT、IL-6、TNF-α水平差异均无统计学意义(P值分别为0.535、0.876、0.973、0.419);不同时间点间各组炎症因子HMGB1、PCT、IL-6、TNF-α的变化存在统计学差异(P0.01),并且观察组HMGB1、IL-6、TNF-α的水平较对照组低(P0.01),而PCT表达差异不存在统计学意义(P=0.059)。Δ3-1HMGB1(第3天与第1天的HMGB1差值)与第3天急性生理与慢性健康(acute physiology and chronic health evaluation system,APACHE)Ⅱ评分呈明显负相关(P0.01),而PCT、IL-6、TNF-α与第3天APACHEⅡ评分均无明显相关关系(P值均大于0.05)。治疗第5天时,急性胰腺炎严重程度床边指数(bedside index for severity in AP,BISAP)观察组明显较对照组低(P=0.038)。观察组的腹痛腹胀时间、排气排便时间、CRRT时间均较对照组短(P值均小于0.01)。观察组的总体有效率也明显高于对照组(P=0.023)。结论:大黄能够有效抑制重症急性胰腺炎患者炎症因子HMGB1、PCT、IL-6、TNF-α的表达,降低BISAP评分,并且能改善SAP患者的症状和转归,而HMGB1表达量变化可能与患者预后相关。
[Abstract]:Objective: to observe the effects of rhubarb enema on the serum high mobility group protein B1C high mobility group B1 HMGB1, procalcitoninine acute, interleukin 6 (IL 6), tumor necrosis factor 伪 necrosis factors 伪 (TNF- 伪) and disease prognosis in severe acute patients with severe acute pancreatitis (SAP). The patients were randomly divided into observation group (30 cases of rhubarb enema) and control group (30 cases of routine treatment group). The serum levels of HMGB1, PCTX, IL-6 and TNF- 伪 were dynamically monitored on 5 days after admission. The remission time of abdominal pain and distension was observed. Results: on the day of treatment, there was no significant difference in the level of HMGB1, PCT1, IL-6, TNF- 伪 between the two groups (P = 0.5350.876n0.973nil 0.419), and the change of HMGB1PCTIL-6TNF- 伪 was statistically significant at different time points. The level of IL-6TNF- 伪 in the observation group was lower than that in the control group, but there was no significant difference in PCT expression between the two groups. 螖 3-1HMGB1 (HMGB1 difference between the 3rd day and the 1st day) and the acute and chronic health evaluation system (Apache che) 鈪，

本文编号：1592711