摘要
目的观察丙氨酰谷氨酰胺联合生长抑素治疗急性重症胰腺炎(SAP)的疗效。方法选取2022年1月—2024年1月北京积水潭医院贵州医院收治的SAP患者108例,根据随机数字表法分为观察组54例和对照组54例。观察组予丙氨酰谷氨酰胺联合生长抑素治疗,对照组予生长抑素治疗,2组均治疗10 d。比较2组临床疗效、临床症状改善时间,治疗前后实验室指标[血淀粉酶(AMY)、D-二聚体(D-D)、C反应蛋白(CRP)、白介素-6(IL-6)]、肠道屏障指标[二胺氧化酶(DAO)、尿乳糖/甘露醇(L/M)值、D-乳酸、内毒素]及不良反应。结果观察组总有效率为94.44%,高于对照组的81.48%(χ^(2)=4.285,P=0.038);观察组腹痛、腹胀、发热及肠道功能障碍改善时间均短于对照组(P<0.01)。治疗10 d后,2组AMY、D-D、CRP、IL-6、DAO、D-乳酸、内毒素水平及L/M值均低于治疗前,且观察组低于对照组(P<0.01)。观察组不良反应总发生率为5.56%,低于对照组的20.37%(χ^(2)=5.252,P=0.022)。结论丙氨酰谷氨酰胺联合生长抑素治疗SAP可获得较高的治疗有效性和安全性,有效改善胃肠功能,更利于肠道屏障功能的恢复。
Objective To observe the curative effect of alanyl glutamine combined with somatostatin in the treatment of severe acute pancreatitis(SAP).Methods A total of 108 SAP patients admitted to Beijing Jishuitan Hospital,Guizhou Hospital from January 2022 to January 2024 were selected and divided into observation group(54 cases)and control group(54 c ases)according to the random number table method.The observation group was treated with alanyl glutamine combined with somatostatin,and the control group was treated with somatostatin.Both groups were treated for 10 days.The clinical efficacy,clinical symptom improvement time,laboratory indexes(AMY,D-D,CRP,IL-6),intestinal barrier indexes[DAO,ur inary lactose/mannitol(L/M),D-lactic acid,endotoxin]before and after treatment,and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was 94.44%,which was higher than 81.48%of the control group(χ^(2)=4.285,P=0.038).The improvement time of abdominal pain,abdominal distension,fever and intestinal dysfunction in the observation group was shorter than that in the control group(P<0.01).After 10 days of treatment,the levels of AMY,D-D,CRP,IL-6,DAO,D-lactic acid,endotoxin and L/M value in the two groups were lower than those before treatment,and the observation group was lower than the control group(P<0.01).The total incidence of adverse reactions in the observation group was 5.56%,which was lower than 20.37%in the control group(χ^(2)=5.252,P=0.022).Conclusion Alanyl glutamine combined with somatostatin in the treatment of SAP can obtain high therapeutic efficacy and safety,effectively improve gastrointestinal function,and is more conducive to the recovery of intestinal barrier f unction.
作者
杨维敏
何伟
YANG Weimin;HE Wei(Beijing Jishuitan Hospital,Guizhou Hospital,Guiyang 550007,China)
出处
《临床合理用药》
2025年第17期23-26,共4页
Chinese Journal of Clinical Rational Drug Use
基金
2023年度贵州省卫生健康委科学技术基金项目(gzwkjz23-373)。
关键词
急性重症胰腺炎
丙氨酰谷氨酰胺
生长抑素
炎性因子
肠道功能
Severe acute pancreatitis
Alanyl glutamine
Somatostatin
Inflammatory factors
Intestinal function
