| 李俊稷,李晓萍,邓朝霞,张 雷,刘明华.醋酸奥曲肽联合乌司他丁对重症急性胰腺炎患者血清ET、MCP-1、TNF-α、IL-6水平及预后的影响[J].,2019,19(15):2911-2914 |
| 醋酸奥曲肽联合乌司他丁对重症急性胰腺炎患者血清ET、MCP-1、TNF-α、IL-6水平及预后的影响 |
| Effect of Octreotide Acetate combined with Ulinastatin on the Serum ET, MCP-1, TNF-α, IL-6 levels and Prognosis of Patients with Severe Acute Pancreatitis |
| 投稿时间：2019-01-24 修订日期：2019-02-19 |
| DOI：10.13241/j.cnki.pmb.2019.15.025 |
| 中文关键词: 醋酸奥曲肽 乌司他丁 重症急性胰腺炎 内皮素 单核细胞趋化因子蛋白1 肿瘤坏死因子-α 白介素-6 预后 |
| 英文关键词: Octreotide acetate Ulinastatin Severe acute pancreatitis Endothelin monocyte chemokine protein 1 Tumor necrosis factor-α Interleukin-6 Prognosis |
| 基金项目:重庆市科技攻关项目(CSTC\2010AC5026) |
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| 摘要 目的：探讨醋酸奥曲肽联合乌司他丁对重症急性胰腺炎血清内皮素(ET)、单核细胞趋化因子蛋白1(MCP-1)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平及预后的影响。方法：纳入我院2017年1月至2018年9月收治的94例重症急性胰腺炎患者，并依据随机数字表法将其分为对照组47例与观察组47例。对照组患者给予乌司他丁治疗，观察组在对照组基础上结合醋酸奥曲肽治疗，两组疗程均为7~14 d。比较两组治疗的疗效，血淀粉酶和尿淀粉酶恢复正常时间，腹痛缓解时间、肠鸣音恢复时间和腹胀缓解时间，治疗前后血清ET、MCP-1、TNF-α、IL-6水平的变化及预后。结果：观察组治疗总有效率(93.62%)显著高于对照组(72.34%)(P<0.05)。观察组血淀粉酶和尿淀粉酶恢复时间、腹痛缓解时间、肠鸣音恢复时间和腹胀缓解时间明显短于对照组(P<0.05)。两组治疗后血清ET、MCP-1、TNF-α和IL-6水平均较治疗前降低(P<0.05)，且观察组以上指标均显著低于对照组(P<0.05)。观察组出院时生存率高于对照组，但差异无统计学意义(P>0.05)。结论：与单用乌司他丁相比，醋酸奥曲肽联合乌司他丁治疗重症急性胰腺炎患者疗效更好，其可显著降低患者血清ET、MCP-1、TNF-α和IL-6水平。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of octreotide acetate combined with ulinastatin on the serum endothelin (ET), monocyte chemokine protein-1 (MCP-1), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and prognosis of severe acute pancreatitis. Methods: 94 cases of patients with severe acute pancreatitis admitted to our hospital from January 2017 to September 2018 were divided into the control group (47 cases) and the observation group (47 cases) according to the random number table method. The control group was treated with ulinastatin, while the observation group was treated with octreotide acetate on the basis of control group. The course of treatment was 7-14 days in both groups. The therapeutic effects including the recovery time of blood amylase and urinary amylase, the relief time of abdominal pain, the recovery time of bowel sounds and the relief time of abdominal distension, changes of serum ET, MCP-1, TNF-alpha, IL-6 levels before and after treatment and prognosis were compared between two groups. Results: The total effective rate of observation group (93.62%) was significantly higher than that of the control group (72.34%) (P<0.05). The recovery time of blood amylase and urine amylase, abdominal pain relief time, bowel sounds recovery time and abdominal distension relief time in the observation group were significantly shorter than those in the control group (P<0.05). The abdominal pain relief time, bowel sounds recovery time and abdominal distension relief time in the observation group were better than those in the control group (P<0.05). After treatment, the levels of serum ET, MCP-1, TNF-α and IL-6 in the two groups were lower than those before treatment (P<0.05), and the above indexes in the observation group were significantly lower than those in the control group (P<0.05). The survival rate of the observation group at discharge was higher than that of the control group, but there was no significant difference (P>0.05). Conclusion: Compared with ulinastatin alone, octreotide acetate combined with ulinastatin is more effective in the treatment of severe acute pancreatitis. It can significantly reduce the levels of serum ET, MCP-1, TNF-alpha and IL-6 in patients with severe acute pancreatitis, and has a good prognosis. |
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