• Seldinger法区域动脉乌司他丁灌注联合奥曲肽治疗重症急性胰腺炎的疗效及其机制
  • Efficacy and anti-inflammatory mechanism of eustatin combined with octreotide in the treatment of severe acute pancreatitis with Seldinger method
  • 濮娜,吴莹,张彩萍.Seldinger法区域动脉乌司他丁灌注联合奥曲肽治疗重症急性胰腺炎的疗效及其机制[J].内科急危重症杂志,2019,25(5):378-380
    DOI:10.11768/nkjwzzzz20190507
    中文关键词:  重症急性胰腺炎  乌司他丁  奥曲肽  炎症反应
    英文关键词:Severe acute pancreatitis  Ulinastatin  Octreotide  Inflammatory response
    基金项目:
    作者单位
    濮娜 大连大学附属新华医院 
    吴莹  
    张彩萍  
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    中文摘要:
          目的: 探讨Seldinger法区域动脉乌司他丁灌注联合奥曲肽对重症急性胰腺炎(SAP)患者血清Ghrelin、巨噬细胞炎性蛋白-1α(MIP-1α)、巨噬细胞炎性蛋白-1β(MIP-1β)水平的影响及临床疗效。方法: 将132例SAP患者按照随机数字表法,分为观察组(乌司他丁+奥曲肽)和对照组(奥曲肽),每组66例。比较2组的临床疗效和血清中C反应蛋白(CRP)、白介素-6(IL-6)以及Ghrelin、MIP-1α、MIP-1β水平,并分析2组并发症发生率及病死率。结果: 观察组治疗有效率高于对照组(80.3% vs 60.6%,P<0.05),且在腹痛缓解时间、首次排便时间、胃肠减压时间及住院时间上均短于对照组(均P<0.05);治疗7 d后,2组血清中CRP、IL-6、Ghrelin、MIP-1α、MIP-1β水平均较治疗前明显下降,且观察组均低于对照组(P<0.05);观察组急性肾衰竭、急性呼吸窘迫综合征、休克及病死率均低于对照组(均P<0.05)。结论: 应用Seldinger法区域动脉乌司他丁灌注联合奥曲肽治疗SAP患者,有利于抑制Ghrelin、MIP-1α、MIP-1β表达,抑制炎症反应,提高临床疗效。
    英文摘要:
          Objective: To investigate the clinical efficacy of ulinastatin perfusion combined with octreotide in patients with severe acute pancreatitis (SAP) by Seldinger's method and its effect on serum Ghrelin, macrophage inflammatory protein -1α (MIP-1α), macrophage inflammatory protein-1β (MIP-1β) expression levels. Methods: A total of 132 patients with SAP were included in the observation group (ulinastatin + octreotide) or control group (octreotide) according to a random number table, with 66 patients in each group. The difference in clinical efficacy and clinical symptoms, and the difference in C-reactive protein (CRP), interleukin-6 (IL-6), Ghrelin, MIP-1α and MIP-1β were compared between two groups. The incidence of complications and mortality were analyzed. Results: The effective rate in observation group was 80.3% (53/66), which was higher than in control group (60.6%, 40/66), and the time to relieve abdominal pain, defecation time, decompression time and hospital stay in observation group were all shorter than in control group (P<0.05). The serum levels of CRP, IL-6, Ghrelin, MIP-1α and MIP-1β after treatment in observation group and control group were significantly lower than those before treatment (P<0.05). The serum levels of CRP, IL-6, Ghrelin, MIP-1α and MIP-1β after treatment in observation group were significantly lower than in control group (all P<0.05). The incidence of acute renal failure, acute respiratory distress syndrome, shock and mortality in observation group were significantly lower than in control group (all P<0.05). Conclusion: The regional artery ulinastatin perfusion combined with octreotide using Seldinger method for SAP patients is beneficial to inhibit the expression of Ghrelin, MIP-1α and MIP-1β, suppress the inflammatory response, thereby reducing the incidence of adverse complications and improving the clinical efficacy.