乌司他丁对急性重症胰腺炎患者血清ZO-1、occludin、IL-18水平影响的多中心研究

Effect of ulinastatin on serum occludin,IL-18,ZO-1 levels in patients with acute severe pancreatitis through multicenter study

目的通过多中心研究,探究乌司他丁对急性重症胰腺炎患者血清ZO-1、occludin、IL-18水平的影响。方法选取2012年4月~2014年6月河北省承德医学院附属医院、隆化县医院以及平泉县医院内科收治的急性重症胰腺炎患者150例,采用随机数字表法分为2组。对照组76例,予西医常规治疗;实验组74例,在常规药物治疗的基础上,加用乌司他丁治疗,比较2组患者治疗前后血清ZO-1、occludin、IL-18水平的变化以及患者疼痛、发热等临床症状。结果治疗后,2组患者血清ZO-1蛋白均有所增加,且实验组(+++)显著高于对照组(+),差异有统计学意义(P<0.05)。治疗后,2组患者血清occludin含量均有所升高,且实验组(128.36±18.21)ng/L显著高于对照组(115.21±12.51)ng/L,差异有统计学意义(P<0.05)。治疗后,2组患者血清IL-18水平均有所下降,实验组为(36.79±10.31)ng/L,显著优于对照组的(42.69±12.35)ng/L,差异有统计学意义(P<0.05)。治疗后,2组患者腹痛、发热症状均有所改善,实验组有效率分别为90%、88%,显著高于对照组的83%、80%,差异有统计学意义(P<0.05)。结论乌司他丁可有效改善急性重症胰腺炎患者血清ZO-1、occludin、IL-18水平,改善患者腹痛、发热症状,是治疗急性重症胰腺炎的有效药物。

Objective To explore the effect of ulinastatin on serum occludin,IL-18,ZO-1 levels in patients with acute severe pancreatitis through multicenter study. Methods 150 patients with acute severe pancreatitis collected in department of medicine from chengde medical college affiliated hospital,longhua county hospital,and pingquan county in Hebei province hospital from April 2012 to June 2014,were divided into two groups by random number table method. Control group(76 cases)were received conventional western medicine treatment; experimental group(74 cases),on the basis of the routine drug treatment,combined with ulinastatin. After a period of treatment,changes of serum ZO-1,occludin,IL-18 levels and clinical symptoms such as pain,fever in two groups before and after treatment were compared. Results After treatment,serum protein ZO-1 in two groups were increased,which in experimental group( + + +)was significantly higher than thatin control group( +)(P < 0. 05); after treatment,occludin content in serum of two groups were all increased,which in experimental group was significantly higher than that in control group(P < 0. 05);serum IL-18 level in the groups all decreased,which in experimental group was significantly lower than that in control group( P < 0. 05);after treatment,the symptoms of abdominal pain,fever in two groups were all improved,the total effective rate in experimental group 98%,88%,was significantly higher than that of control group(83%,80%)(P < 0.05). Conclusion Ulinastatin could effectively improve serum occludin,IL-18,ZO-1 levels in patients with acute severe pancreatitis,and improve the symptoms of abdominal pain and fever. It is an effective drug for the treatment of acute severe pancreatitis.