乌司他丁区域动脉灌注联合连续性血液净化治疗急性重症胰腺炎的临床效果

Effects of Combined Application of Ulinastin Local Arterial Infusion and Continuous Blood Purification Therapy on Inflammatory Cytokines and Immune Function in Severe Acute Pancreatitis

目的:探讨乌司他丁区域动脉灌注联合连续性血液净化对重症急性胰腺炎患者血清炎症因子水平及免疫功能的影响。方法:选择笔者所在医院重症医学科收治的急性重症胰腺炎患者48例,入院6 h内即行乌司他丁区域动脉灌注联合连续性血液净化治疗,于治疗开始0、12、24、48 h留血,流氏细胞分析法测定T细胞亚群CD4^+、CD8^+、计算CD4^+/CD8^+比值;酶联免疫吸附法检测患者外周血IL-1、TNF-a的浓度,并观察在0、12、24、48 h时相的APACHEⅡ评分。结果:患者经治疗后淋巴细胞CD4^+、CD8^+、CD4^+/CD8^+比值明显升高,差异均有统计学意义(P<0.05),于24 h达高峰;炎症因子IL-1、TNF-a水平下降,差异均有统计学意义(P<0.05);APACHEⅡ评分明显下降,差异有统计学意义(P<0.05)。结论:乌司他丁区域动脉灌注联合连续性血液净化治疗重症急性胰腺炎的临床疗效显著,值得临床推广。

Objective： To investigate the effects of Ulinastin regional artery perfusion combined of continuous blood purification therapy on inflammatory cytokines and immune function in severe acute pancreatitis.nethod： 48 cases of severe acute pancreatitis patients admitted to the author＇s hospital intensive medicine were selected, all were given Ulinastin regional artery perfusion and continuous blood purification therapy within 6 hours, at the time of 0, 12, 24, 48 h during the treatment, got blood specimen, FCM employed to detect CD4＋, CD8＋, calculating the ratio of CD4＋/CD8＋; ELISA method to detect IL-1, TNF-a, and observe in 0, 12, 24 and 48 h phase of APACHE I1 scores.Results： SAP patients after treatment lymphocyte CD4＋, CD8＋, CD4＋/CD8＋ ratio increased significantly（P〈0.05）, peak in 24 hours; Inflammatory cytokines IL-1, TNF-a level decreased （P〈0.05）; APACHE II score significantly decreased （P〈0.05）. Conclusion： Ulinastatin regional artery perfusion combined continuous blood purification therapy for severe acute pancreatitis clinical curative effect is distinct, worth clinical promotion.