乌司他丁对急性胰腺炎血清C反应蛋白的影响及疗效观察

Effect of Ulinastatin on Serum C-reactive Protein in Acute Pancreatitis

目的探讨乌司他丁对轻症及重症不同分型急性胰腺炎的临床疗效,并观察其对血清C反应蛋白的影响。方法 64例急性胰腺炎(AP)患者随机分为治疗组和对照组各32例,每组分为轻症、重症各18例,14例。对照组给予常规治疗,治疗组在常规治疗的基础上加用乌司他丁治疗。观察比较两组血清C反应蛋白的变化,有效率、临床症状改善情况,及并发症的发生率及病死率。结果 1)治疗前两组血清C反应蛋白含量无明显差别,治疗后两组血清C反应蛋白含量均降低,以治疗组降低最为明显,两组间比较有统计学差异(P<0.01)。2)治疗组的有效率为96.88%(31/32),对照组有效率为87.50%(28/32),两组比较差异有统计学意义(P<0.05)。且两组重症患者的总有效率比较,治疗组有效率(92.85%)明显高于对照组(71.40%)(P<0.05)。3)治疗组的腹痛缓解时间、血淀粉酶复常时间以及胰腺水肿改善时间优于对照组,差异有统计学意义(P<0.05)。4)治疗组低氧血症的发生率明显低于对照组,差异有统计学意义(P<0.05)。结论在常规治疗基础上加用乌司他丁可改善各项指标,降低急性胰腺炎并发症的发生率,缓解和改善各种临床症状、体征,经济方便,是一种值得临床推广的治疗方法 。

Objective To investigate the clinical efficacy of ulinastatin in the treatment of mild and severe acute pancreatitis and to observe its effect on the serum C-reactive protein. Methods Sixty-four cases of acute pancreatitis were randomly divided into treatment group （32 cases）and control group（32 cases）,and each group was,in turn,divided into severe cases（ 18 cases）and mild cases（ 14 cases）. Both treatment group and control group were given conventional therapy, and ulinastatin was added to the treatment group. The changes of serum C-reactive protein, efficiency and improvement of clinical symptoms, and the incidence of complications and mortality in the two groups were observed and compared. Results 1 ）There was no significant difference in the serum C-reactive protein level in the two groups before therapy,the serum C-reactive protein level was decreased in both groups after treatment but the treatment group showed an obvious decrease in it compared with the control group,with a significant difference in the serum C-reactive protein level between the two groups（P〈0.01 ）. 2）The effective rate of the treatment group was 96.88% （31/32）,and that of the control group was 87.50% （28/32）,with a significant difference between the two groups（P〈0.05 ））. The total effective rate of severe acute pancreatitis cases of the treatment group was 92.85%,obviously higher than that of the control group（71.40% ）,with a significant difference（P〈0.05）. 3）The treatment group was superior to the control group in the relief time of abdominal pain, time of serum amylase returning to normal and time of pancreatic edema improvement, with a significant difference （P〈 0.05 ）. 4）The incidence of hypoxemia in the treatment group was significantly lower than that of the control group,with a significant difference（P〈 0.05 ）. Conclusion The conventional therapy plus ulinastatin for acute pancreatitis can improve some indicators and reduce the incidence of complications,mitigation and improvement of a variety of clinical symptoms and signs,which is economical and convenient,worthy of being popularized in clinical treatment.