生长抑素联合前列地尔对重症急性胰腺炎患者的疗效及对TNF-αIL-6的影响

The Effect of Somatostatin Combined with Alprostadil in the Treatment of Severe Acute Pancreatitis and its Influence on TNF- alpha IL- 6

目的:研究生长抑素联合前列地尔对急诊重症急性胰腺炎(SAP)患者的疗效及对肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)的影响。方法:选择2012年6月至2015年5月接受治疗的SAP患者96例实施研究,根据数字随机法分成观察组以及对照组两组,每组各有48例患者。两组均予以常规禁食、胃肠减压以及抗生素等对症支持性治疗。对照组增用生长抑素,观察组在对照组基础上增用前列地尔,治疗2周后比较两组不同治疗方式的疗效,两组症状体征相关指标,内毒素、TNF-α及IL-6水平,以及药物不良反应。结果:观察组经过治疗后的总有效率为95.83%,较对照组的81.25%显著更高(P<0.05)。观察组的腹痛缓解所需时间、肠功能恢复所需时间、血淀粉酶恢复所需时间以及ICU住院时间均分别少于对照组(P<0.05)。两组治疗前的内毒素、TNF-α及IL-6水平无统计学差异。观察组治疗后的内毒素、TNF-α及IL-6水平均分别显著低于对照组(P<0.05)。两组不良反应比较,差异无统计学意义。结论:利用前列地尔以及生长抑素对SAP患者实施联合治疗,疗效较好,能够加速患者症状恢复,还可减少炎性介质的释放,安全性较高,值得退广应用。

Objective： To study the curative effect of somatostatin combined with alprostadil in the treatment of severe acute pancreatitis and its influence on TNF- alpha,IL- 6. Method： From June 2012 to May 2015 in our hospital,96 cases of SAP patients were randomly divided into observation group and control group,48 cases in each group. The two groups were treated with routine fasting,gastrointestinal decompression,antibiotics and other symptomatic supportive treatment. The control group,additionally,were given somatostatin,the observation group were added with alprostadil based on the control group,the efficacy between the two groups of different treatment methods after 2 weeks of treatment was compared,the symptoms and signs related indicators,endotoxin,TNF- a and IL- 6 levels,and adverse drug reactions of the two group were also compared. Result： The total effective rate of the observation group was 95. 83%,which was significantly higher than that in the control group（ P〈0. 05）. The required time of alleviating pain,intestinal function recovery time,blood amylase recovery time and length of hospital stay in the observation group were significantly less than those in the control group,the difference was statistically significant（ P 0.05）. There was no significant difference in the levels of endotoxin,IL- 6 and TNF- before treatment in the two groups. After treatment,the levels of endotoxin,TNF- and IL- 6 in the observation group were significantly lower than those in the control group,the difference was statistically significant（ P〈0. 05）,the difference of the adverse reactions in the two groups was not significant. Conclusion： In the use of alprostadil and somatostatin in patients with SAP,curative effect is better,the combination therapy can accelerate the recovery of patients with symptoms,reduce the inflammatory medium release,and has high security,which is worthy of wide application.