乌司他丁和奥曲肽联合治疗重症急性胰腺炎的疗效及血流变学观察

Observation of hemorrheology and clinical efficacy on ulinastatin combined with octreotide in treatment of severe acute pancreatitis

目的探讨乌司他丁和奥曲肽治疗重症急性胰腺炎患者疗效及血流变学的影响。方法将福建医科大学附属第二医院收治的92例重症急性胰腺炎(severe acute pancreatitis,SAP)患者分对照组和治疗组(n=46),2组均采用常规治疗,对照组加用奥曲肽,治疗组加奥曲肽联合乌司他丁治疗,观察治疗前后2组C-反应蛋白、血流变学及临床疗效、并发症。结果治疗后治疗组全血粘度、血浆比粘度、血小板粘附率下降明显,与对照组比较差异有统计学意义(P<0.05);与对照组比较,治疗组C反应蛋白在治疗后第5 d和第10 d下降明显,差异有统计学意义(P<0.05);治疗组并发症减少,治疗组的总有效率(89.13%)明显高于对照组的总有效率(69.57%),差异有统计学意义(P<0.05)。结论乌司他丁联合奥曲肽能改善血流变学,降低C反应蛋白,利于重症急性胰腺炎的恢复。

Objective To evaluate the clinical efficacy and hemorrheology on ulinastatin combined with octreotide in treatment of severe acute pancreatitis. Methods 92 cases of severe acute pancreatitis(SAP)were divided into two groups: 46 in control group and 46 in treatment group. The two groups were treated with traditional treatment. The control group was treated with octreotide in addition. The treatment group was treated with octreotide and ulinastatin in addition. The C reactive protein,blood rheology,the clinical curative effect and complications were detected before and after treatment. Results Compared with the control group,blood viscosity,plasma specific viscosity and platelet adhesion rate were decreased after treatment,there was statistical significance(P < 0. 05); in treatment group,C reactive protein in fifth and tenth day were lower than the control group(P < 0. 05);complications were reduced in treatment group,the total effective treatment group(89. 13%)was significantly higher than that of control group in the total efficiency(69. 57%),the difference was statistically significant( P < 0. 05). Conclusion Ulinastatin combined with octreotide can improve the blood rheology,lower C reactive protein,beneficial to the recovery of patients with severe acute pancreatitis.