血液净化治疗对重症急性胰腺炎患者血清IL-6等水平及病情的影响

Effects of blood purification on serum Interleukin-6,Procalcitonin, and C-reactive protein in patients with severe acute pancreatitis

目的探讨血液净化治疗对重症急性胰腺炎(severe acute pancreatitis,SAP)患者血清炎性因子白细胞介素6(interleukin-6,IL-6)、降钙素原(procalcitonin,PCT)及C反应蛋白(C-reactiveprotein,CRP)水平及病情的影响。方法研究对象选取2015年3月-2018年3月徐州医科大学附属医院收治的SAP患者64例,随机分为对照组和观察组。对照组32例患者给予常规治疗,观察组32例患者在对照组基础上给予血液净化治疗。比较两组IL-6、PCT、CRP水平,两组治疗前后血清淀粉酶(amylase,AMY),多器官功能障碍评分(multiple organ dysfunction syndrome score,MODS),腹痛消失时间、腹胀消失时间、肠鸣音恢复时间、排便恢复时间、住院天数。结果治疗后24、48、72 h两组血清IL-6、PCT及CRP水平较治疗前均有所下降,但观察组的水平显著低于对照组(P<0.05)。治疗后24、48、72 h两组AMY含量及MODS评分均较治疗前下降,但观察组显著低于对照组(P<0.05)。观察组腹痛消失时间、腹胀消失时间、肠鸣音恢复时间、排便恢复时间、住院天数均显著低于对照组(P<0.05)。结论血液净化治疗可显著降低SAP患者血清IL-6、PCT及CRP等炎症因子水平,有利于患者肠功能的恢复,尽早恢复肠内营养,改善患者总体病情,缩短患者住院时间。

Objective To study the effects of blood purification on serum Interleukin-6 (IL-6),Procalcitonin (PCT)and C-reactive protein (CRP)in patients with severe acute pancreatitis (SAP).Methods Sixty-four patients with SAP who were admitted emergency department at affiliated Hospital of Xuzhou Medical University in between March 2015 and March 2018 were randomly divided into two groups.In the control group,32 patients were given routine treatment,and 32 patients in the observation group were given blood purification in addition to the routine treatment.The levels of IL-6,PCT,CRP,and the serum amylase (AMY),multiple organ dysfunction syndrome seore(MODS score)were measured.The time of disappearance of abdominal pain,the time of disappearance of abdominal distension,the time of recovery of bowel sounds,the time of defecation and the time of hospitalization were also compared between the two groups.Results The levels of serum IL-6,PCT and CRP at 24 h,48 h,and 72 h after treatment were lower than those before treatment in the two groups.There were significantly lower levels of IL-6,PCT and CRP between the two groups (P <0.05).The serum AMY and MODS score in both groups were lower at 24 h,48 h and 72 h after treatment as compared with those before treatment,and the icy,el in the observation group was significantly lower than that in the control group (P <0.05).The time of disappearance of abdominal pain,the time of disappearance of abdominal distension,the time of recovery of bowel sound,the time of defecation and the time of hospitalization of the observation group were also significantly lower than those of the control group (P <0.05).Conclusion Blood purification can significantly reduce the levels of IL-6,PCT and CRP in patients with SAP,which is beneficial to the recovery of the clinical conditions.