乌司他丁联合奥曲肽治疗急性胰腺炎的疗效及对细胞因子和淀粉酶的影响

Curative effect of ulinastatin combined with octreotide in the treatment of acute pancreatitis and its influence on cytokines and amylase

目的:探讨乌司他丁联合奥曲肽治疗急性胰腺炎的临床疗效以及对细胞因子和淀粉酶的影响。方法:选取在本院接受治疗的急性胰腺炎患者168例,将其随机分为乌司他丁组、奥曲肽组和联合治疗组3组,每组各56例。3组均进行常规治疗,在此基础上,乌司他丁组给予乌司他丁静脉滴注,奥曲肽组给予奥曲肽静脉泵注,联合用药组给予两种制剂的联合应用。观察3组临床治疗效果以及治疗前后细胞因子和淀粉酶的变化情况。结果:联合治疗组总有效率明显高于乌司他丁组和奥曲肽组,差异具有统计学意义(P<0.05)。3组治疗后细胞因子和淀粉酶水平都有一定程度的改善,而乌司他丁组和奥曲肽组对细胞因子和淀粉酶变化的影响是一致的,差异无统计学意义(P>0.05);而联合治疗组细胞因子和淀粉酶水平变化明显优于单独用药组,且差异均具有统计学意义(P<0.05)。结论:乌司他丁和奥曲肽联合应用治疗急性胰腺炎在改善患者临床症状和体征、降低细胞因子和淀粉酶等方面都要明显优于两种药物单独使用,具有更好的治疗效果,值得临床大力推广和应用。

Objective： To study the curative effects of Ulinastatin combined octreotide in the treatment of acute pancrea- titis and the effect of cytokines and amylase. Methods： 168 patients with acute pancreatitis were collected and randomly divided into ulinastatin group, the peptide group and combination group, with 56 cases in each group. All three groups were given reg- ular treatment, on this basis, the ulinastatin group was given ulinastatin intravenous drip, octreotide group was given the pep- tide intravenous injection pump, combination group was given ulinastatin combined octreotide. The changes of cytokines and amylase before and after clinical treatment were tested. Results： The total effective rate of combination group was 92.86 %, significantly higher than 76.79% of ulinastatin group and the 78.57% of octreotide group （P〈0.05）. After treatment, cyto- kines and amylase levels were improved significantly. The changes of cytokines and amylase levels of ulinastatin group and oct- reotide group was consistent, there was no statistically significant difference （P〉 0.05）. But the changes of cytokines and am- ylase levels of combination group was obviously better than the separate treatment group, and the differences were statistically significant （P〈0. 05）. Conclusion, Ulinastatin combined with octreotide in treatment of acute pancreatitis has better treatment effect in improving patients clinical symptoms and signs, reducing cytokines and amylase levels, is worth promoting.