摘要
目的:评价生长抑素联合前列地尔治疗重症急性胰腺炎(SAP)的临床疗效并探讨其作用机制。方法:将69例SAP患者分为生长抑素联合前列地尔组(联合组)和单用生长抑素组(对照组),观察2组患者血内毒素、TNF-α、IL-6、血浆内血小板颗粒膜蛋白(GMP140)、血栓素B2(TXB2)、血管性假血友病因子相关抗原(vWF:Ag)水平的变化,比较2组患者治疗前和治疗后14dAPACHEⅡ评分及Binder评分,平均ICU住院时间及28d病死率。结果:2组患者入院时血内毒素、TNF-α、IL-6、GMP140、TXB2、vWF:Ag均高于正常,治疗后降低,联合组较对照组下降的趋势更明显(均P<0.05)。治疗后与对照组比较,联合组APACHEⅡ评分及Binder合并症评分降低更为明显(P<0.05);ICU住院时间明显缩短(P<0.05);病死率显著下降(P<0.05)。结论:生长抑素联合前列地尔治疗SAP比单独应用生长抑素更能抑制炎症介质释放,改善胰腺微循环障碍,缩短ICU住院日。
Objective： To evaluate the therapeutic effect of somatostatin combined with LipoPGE1 in treatment of patients with severe acute pancreatitis （SAP） and to explore its mechanism. Methods： Sixty-nine patients with SAP were allocated into the somatostatin combined with LipoPGE1 group （combination group） and the somatostatin group （control group）. Changes of serum LPS, TNF-α, IL-6, GMPI40, TXB2, vWE：Ag were determined. APACHE Ⅱ scores, Binder scores, average duration in ICU, mortality rate were compared between two groups before treatment and 14 days after treatment. Results： The serum level of LPS, TNF-α, IL-6,GMP140, TXB2, vWF：Ag were increased a- bove normal levels in both groups, and descended after treatment. Compared with the control group, patients in combi- nation group had a significant lower value of those parameters, as well as the APACHE II and Binder scores （P 〈 0. 05） , the duration in ICU shortened and the mortality decreased significantly （ P 〈 0.05 ）. Conclusions ： Combination use of somatostatin and LipoPGE1 could significantly inhibit the releasing of inflammatory media, improve the pancreas microcirculation and shorten the duration of stay in ICU.
出处
《内科急危重症杂志》
2013年第2期90-92,共3页
Journal of Critical Care In Internal Medicine
