L-谷氨酰胺呱仑酸钠治疗重症急性胰腺炎的临床疗效研究

The clinical efficacy of L-Glutamine and Sodium Gualenate on patients with severe acute pancreatitis

[目的]观察早期肠内营养添加L-谷氨酰胺呱仑酸钠对重症急性胰腺炎（SAP）的临床疗效。[方法]收集2013年3月~2014年8月我院收治的SAP患者74例,分为常规治疗对照组和L-谷氨酰胺呱仑酸钠观察组,每组37例。另取我院体检中心健康体检者40例作为正常对照。ELISA法检测IL-2、IL-6、TNF-α表达。[结果]对照组临床症状消失、血淀粉酶恢复以及住院时间分别为：（5.67±1.32）d、（6.43±1.61）d和（14.92±3.55）d,均显著高于观察组的（3.12±0.56）d、（4.24±1.05）d和（9.47±2.42）d（P〈0.05）。治疗前对照组和观察组IL-2、IL-6、TNF-α表达差异无统计学意义（P〉0.05）,但均显著高于健康对照组（P〈0.01）。治疗后观察组对IL-2、IL-6、TNF-α的减低作用显著优于对照组（P〈0.01）。观察组的治疗有效率为94.6%显著优于对照组的78.4%（P〈0.05）。[结论]L-谷氨酰胺呱仑酸钠可以显著抑制SAP患者的炎症反应,临床疗效显著,值得临床推广使用。

[Objective]To detect the clinical efficacy of L-Glutamine and Sodium Gualenate on patients with severe acute pancreatitis（SAP）.[Methods]Seventy-four SAP patients from our hospital were enrolled in this study.Patients were divided into：control group（n=37）and observation group（n=37）.Forty healthy people were used as normal control.ELISA analysis was used to determine the expression of IL-2,IL-6,and TNF-α.[Results]The duration for the clinical signs to disappear,for blood amylase to recover to normal,and the average hospital stay in control group were 5.67±1.32 d,6.43±1.61 d,and 14.92±3.55 d,which were significantly higher than that of 3.12±0.56 d,4.24±1.05 d,and 9.47±2.42 din observation group（P〈0.05）.Before treatment,the expression of IL-2,IL-6,and TNF-αwas not significantly different between control and observation group（P〉0.05）,which was all significantly higher than that in healthy control group（P〈0.01）.After treatment,the decrease of IL-2,IL-6,and TNF-αwas better in observation group than that in control group（P〈0.01）.The clinical effective rate in observation was 94.6%,which was higher than78.4%in control group（P〈0.05）.[Conclusion]L-Glutamine and Sodium Gualenate can inhibit inflammatory reaction in SAP patients and shows significant clinical effects,which is worthy of clinical application.