| 摘要: |
| 目的：研究乌司他丁联合血必净注射液治疗重症急性胰腺炎的临床疗效及其对氧化应激、肠黏膜保护作用的效果。方法：收集 134 例重症急性胰腺炎患者，按照随机数表方法分为对照组（常规治疗加用乌司他丁）、研究组（常规治疗加用乌司他丁联合血必净注射液）各 67 例，对比两组炎症因子指标（IL-6、IL-8、TNF-α、CRP）、氧化应激指标（SOD、 MDA、NO）、免疫功能指标（CD3+、CD4+、CD8+、CD4+/CD8+）、肠黏膜受损程度指标（DAO、内毒素、D- 乳酸）、临床相关指标以及临床疗效。结果：治疗后研究组 IL-6、IL-8、TNF-α、CRP 水平均明显低于对照组（P<0.05），研究组降低炎症反应效果优于对照组；研究组 SOD、NO 水平明显高于对照组，MDA 水平明显低于对照组（P<0.05），研究组改善氧化应激明显优于对照组；研究组 CD3+ 略高于对照组，但无统计学差异（P>0.05）；CD4+、CD4+/CD8+ 明显高于对照组，CD8+ 明显低于对照组（P<0.05），可见，研究组对调节机体免疫功能效果优于对照组；研究组 DAO、内毒素、D- 乳酸指标均明显低于对照组（P<0.05），研究组改善肠黏膜受损程度的效果优于对照组；研究组腹痛消失时间、腹胀消失时间及血清淀粉酶恢复时间均明显的短于对照组（P<0.05）；研究组总有效率 96 %，与对照组比较有统计学差异（P<0.05）。结论：乌司他丁联合血必净注射液治疗重症急性胰腺炎，临床疗效显著，与单用乌司他丁相比，更有助于改善炎症反应，抑制氧化应激， 提升机体免疫功能，更好地保护肠黏膜，促进康复。 |
| 关键词: 乌司他丁 血必净注射液 重症急性胰腺炎 氧化应激 肠黏膜保护 |
| DOI：10.3969/j.issn.1007-6948.2019.05.004 |
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| 基金项目: |
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| Effect of Ulinastatin Combined with Xuebijing on Severe Acute Pancreatitis |
| HU Yun-ming,CHAN Yun- feng,HUANG Pei-pei |
| Department of Hepatobiliary Surgery, the First Af?liated Hospital of Wenzhou Medical University, Wenzhou (325000), China |
| Abstract: |
| Objective To study the clinical efficacy of ulinastatin combined with Xuebijing Injection in the treatment of severe acute pancreatitis and its effect on oxidative stress and intestinal mucosal protection. Methods Totally 134 patients with severe acute pancreatitis were enrolled in this study. According to the random number table method, they were divided into control group (conventional treatment+ulinastatin) and treatment group (conventional treatment+ulinastatin combined with Xuebijing Injection), 67 cases in each group. The inflammatory factor indicators (IL- 6 , IL- 8 , TNF-α and CRP), oxidative stress indicators (SOD, MDA and NO), immune function indicators (CD3+, CD4+, CD8+ and CD4+/CD8+), indexes of intestinal mucosal damage (DAO, endotoxin and D-lactic acid), clinically relevant indicators and clinical efficacy in two groups were compared. Results After treatment, the levels of IL-6, IL-8, TNF-α and CRP in the treatment group were signi?cantly lower than those in the control group (P<0.05). The reduction of in?ammatory response in the treatment group was better than that in the control group; the SOD and NO levels in the treatment group were signi?cantly higher than those in the control group. In the treatment group, the MDA level was signi?cantly lower than that in the control group (P<0.05). The oxidative stress in the treatment group was signi?cantly better than that in the control group. The CD3+ in the treatment group was slightly higher than that in the control group, but there was no statistical difference (P > 0. 05); CD4+ and CD4+/CD8+ were significantly higher than those in the control group, CD8+ was signi?cantly lower than that in the control group (P<0.05). It can be seen that the treatment group was better than the control group in regulating the immune function of the body; the DAO, endotoxin and D-lactic acid indexes in the treatment group were signi?cantly lower than those in the control group (P <0.05), the effect of improving the degree of intestinal mucosal damage was better in the treatment group than that in the control group; the disappearance time of abdominal pain, disappearance time of abdominal distension and recovery time of serum amylase in the treatment group were signi?cantly shorter than those in the control group (P<0.05). The total effective rate of the treatment group was 96%, which was statistically different from the control group (P<0.05). Conclusion The clinical ef?cacy of ulinastatin combined with Xuebijing Injection in the treatment of severe acute pancreatitis is signi?cant, and it is more helpful to improve in?ammatory response, inhibit oxidative stress, improve immune function, better protect intestinal mucosa, and promote the recovery of patients. |
| Key words: Ulinastatin Xuebijing Injection severe acute pancreatitis oxidative stress intestinal mucosal protection |
