乌司他丁对急性胰腺炎患者血小板参数的影响

Effects of Ulinastatin on The Platelet Parameter in Patients with Acute Pancreatitis

目的探讨急性胰腺炎(acute pancreatitis,AP)患者血小板参数的变化特点及应用乌司他丁(ulinas-tatin,UTI)治疗对血小板参数的影响。方法回顾性分析解放军第421医院2005年3月至2007年3月收治的80例AP患者的临床资料,按病情严重程度分为轻症急性胰腺炎(MAP)43例和重症急性胰腺炎(SAP)37例,以同期健康体检者30例作为对照组。应用血细胞自动分析仪检测不同时期外周血血小板计数(PLT)、血小板容积(PCT)、平均血小板体积(MPV)和血小板分布宽度(PDW)。结果入院时,MAP组PLT和PCT与对照组比较差异无统计学意义(P>0.05),而MPV和PDW则较对照组升高(P<0.05);SAP组与MAP组比较,PLT和PCT明显下降(P<0.01),而MPV和PDW显著升高(P<0.05)。治疗1周后,MAP组PLT和PCT与入院时比较差异无统计学意义(P>0.05),MPV和PDW降低(P<0.05);SAP组PLT和PCT较入院时明显升高(P<0.05,P<0.01),而MPV和PDW则明显降低(P<0.01,P<0.05)。MAP组常规治疗患者PLT和PCT低于UTI治疗患者(P<0.05),MPV和PDW无差异(P>0.05);SAP组常规治疗患者PLT和PCT亦明显低于UTI治疗患者(P<0.01,P<0.05),而MPV和PDW则明显高于UTI治疗患者(P<0.01)。结论AP患者血小板参数出现变化,SAP患者血小板参数变化较MAP患者明显。UTI可升高PLT和PCT,降低血小板的活性,对SAP患者具有一定的治疗和预防病情恶化的作用。

Objective To investigate the change of the platelet parameter and to study the therapeutic effects of ulinastatin （UTI） on platelet parameter in patients with acute pancreatitis （AP）. Methods The data of 80 patients with AP were analyzed retrospectively. All patients were divided into two groups： mild acute pancreatitis （MAP, n=43） and severe acute pancreatitis （SAP, n= 37）. Thirty people who took the medical examination and whose results were normal were included as control group. The autocytometer was used to test PLT, PCT, MPV and PDW in different periods of SAP. Results On admission, there were no significant differences of PLT, PCT between MAP group and control group （P〉0.05）, but MPV and PDW in MAP group were higher than those of control group （P〈0.05）. Compared with MAP group, PLT and PCT decreased markedly in SAP group （P〈 0.01）, while MPV and PDW significantly increased （P〈0.05）. After 1-week treatment of UTI, PLT and PCT in MAP group didn＇t change dramatically, while MPV and PDW decreased significantly （P〈0.05）. While in SAP group, PLT and PCT increased significantly （P〈0.05, P〈0.01）, and MPV and PDW decreased significantly （P〈 0.01, P〈0.05）. Compared with conventional treatment, PLT and PCT in MAP group increased significantly in UTI treatment group （P〈0.05）, but there was no statistical difference in terms of MPV and PDW （P〉0.05）. However, SAP group showed significant increase of PLT and PCT （P〈0.01, P〈0.05） and decrease of MPV and PDW in UTI treatment group compared with patients treated by conventional methods （P〈0.01）. Conclusion The platelet parameter changes in patients with acute pancreatitis, and the changes of SAP patients are more mark than those of MAP patients. UTI can significantly increase PLT and PCT, and significantly decrease the activity of the platelet. Therefore, UTI may take a role in the treatment and prevention for SAP.