摘要
目的探讨前列地尔联合血必净治疗急性重症胰腺炎的疗效及对血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、降钙素原(PCT)的影响。方法选择2016年1月至2018年2月我院接诊的急性重症胰腺炎患者105例,通过随机数表法分为观察组55例和对照组50例,在常规疗法基础上,对照组给予血必净治疗,观察组在对照组基础上联合前列地尔治疗,2组均连续治疗1周。比较2组临床疗效、症状体征、血尿淀粉酶、血清TNF-α、IL-6、PCT指标改善情况及不良反应。结果治疗后,观察组临床疗效总有效率为98%,对照组为88%,观察组临床疗效总有效率明显高于对照组,差异均有统计学意义(P<0.05);观察组治疗后腹部压痛缓解时间为(3.8±1.4)d,腹痛缓解时间为(2.5±0.8)d,血淀粉酶恢复正常时间为(4.2±1.3)d;对照组治疗后腹部压痛缓解时间为(5.1±1.6)d,腹痛缓解时间为(4.9±1.0)d,血淀粉酶恢复正常时间为(6.6±1.5)d;观察组腹部压痛缓解时间、腹痛缓解时间、血淀粉酶恢复正常时间均短于对照组,差异均有统计学意义(P<0.05);2组血尿淀粉酶、血清TNF-α、IL-6、PCT在组间、不同时间点和组间×不同时间点之间交互作用差异有统计学意义(P<0.05);观察组总不良反应发生率为4%,对照组为8%,2组不良反应总发生率差异无统计学意义(P>0.05)。结论前列地尔联合血必净能提高急性重症胰腺炎的临床治疗,通过调节血清TNF-α、IL-6、PCT的指标水平,改善病情,临床应用价值高,应大力推广。
Objective To study the effect of alprostadil combined with Xuebijing on acute severe pancreatitis and its influence on serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and procalcitonin(PCT)levels.Methods A total of 105 patients with severe acute pancreatitis admitted to our hospital from January 2016 to February 2018 were selected for the study,they were randomly divided into observation group(55 cases)and control group(50 cases).On the basis of routine treatment,the control group was treated with Xuebijing.the observation group was treated with alprostadil on the basis of the control group.Both groups were treated continuously for one week.the clinical efficacy,symptoms and signs,serum and urine amylase,serum TNF-α,IL-6 and PCT and adverse reactions were compared between the two groups.Results After treatment,the total effective rate of clinical effect in the observation group was 98%,and that in the control group was 88%.The total effective rate of clinical effect in the observation group was significantly higher than that in the control group,there are obvious differences(P<0.05);the relief time of abdominal tenderness in the observation group was(3.8±1.4)d after treatment,the time of abdominal pain relief was(2.5±0.8)d after treatment,the time of amylase recovery was(4.2±1.3)d after treatment,the relief time of abdominal tenderness in the control group was(5.1±1.6)d after treatment,the time of abdominal pain relief was(4.9±1.0)d after treatment,the recovery time of serum amylase was(6.6±1.5)d after treatment,the time of abdominal tenderness relief,abdominal pain relief and blood amylase recovery in the observation group were shorter than those in the control group,there are obvious differences(P<0.05);the observation group before and after blood amylase treatment were(2786±357)U/L,(1069±217)U/L,and urine amylase treatment were(641±29)U/L,(102±12)U/L,serum TNF-αbefore and after treatment were(45±7)pg/L,(15±7)pg/L,and IL-6 before and after treatment were(26.4±2.1)pg/L,(7.5±0.8)pg/L,before and after PCT treatment were(8.6±1.1)ng/ml,(1.3±0.4)ng/ml;control group blood amylase before and after treatment were(2790±330)U/L,(1802±317)U/L,before and after treatment,urinary amylase was(644±29)U/L and(135±13)U/L respectively,the serum TNF-αbefore and after treatment were(46±7)pg/L,(19±7)pg/L,and IL-6 before and after treatment were(26.7±2.2)pg/L,(9.7±0.9)pg/L,before and after PCT treatment were(8.7±1.1)ng/ml,(2.7±0.9)ng/ml;the urinary amylase,serum TNF-α,IL-6,and PCT between the two groups were statistically significant at different time points and between groups and at different time points(P<0.05);the total incidence of adverse reactions was 4%in the control group and 8%in the control group.There was no significant difference between the two groups(P>0.05).Con-clusions Alprostadil combined with Xuebijing can improve the clinical treatment of severe acute pancreatitis,by adjusting the levels of serum TNF-α,IL-6 and PCT,the condition of the patients can be improved,the clinical application value is high and should be vigorously promoted.
作者
信然然
霍丽丽
刘岩
Xin Ranran;Huo Lili;Liu Yan(Department of Emergency,Tianjin Beichen Hospital,Tianjin 300400,China)
出处
《山西医药杂志》
CAS
2020年第2期137-140,共4页
Shanxi Medical Journal
关键词
前列地尔
血必净
胰腺炎
急性坏死性
血清炎症因子
Alprostadil
Xuebijing
Pancreatitis,acute necrotizing
Serum inflammatory factors
