血浆置换疗法在高脂血症胰腺炎患者中的应用及对炎性因子水平的影响

The application of plasma exchange therapy in patients with hyperlipidemic pancreatitis and its effect on the levels of inflammatory factors

目的观察血浆置换疗法在高脂血症胰腺炎患者中的治疗效果及对炎性因子水平的影响。方法取高脂血症胰腺炎患者60例，随机分为对照组（n=30）和观察组（n=30）。对照组采用内科传统治疗，观察组采用血浆置换疗法治疗，采用酶联免疫吸附法（ELISA）检测患者治疗前、后TNF-α、IL-2、IL-6及IL-8水平，比较两组临床治疗效果及对炎性因子水平。结果观察组治疗后血常规WBC、AMY、GLU及血脂水平，低于对照组[（7．84±1．20）×10^9／L比（10．94±1．43）×10^9／L、（200．52±17．31）U／L比（425．12±20．64）U／L；（7．04±1．02）mmol／L比（9．04±2．51）mmol/L;（5．93±1．57）mmol／L比（10．49±4．26）mmol／L]（P〈0．05）；观察组治疗后炎症因子TNF-α、IL-2、IL-6及IL-8水平低于对照组[（172．4±56．2）pg／ml比（246．7±96．4）pg／ml、（26．6±9．0）pg／ml比（41．4±11．1）pg／ml、（31．5±8．5）pg／ml比（134．4±37．8）pg／ml、（62．7±16．2）pg／ml比（149．5±28．3）pg／ml]（P〈0．05），两组IL-10治疗前[（24．6±153）pg／ml比（56．4±24．4）pg／ml]、治疗后[（116．7±34．6）pg/ml比（119．5±23．6）pg／ml]水平比较变化不明显（P〉0．05）；观察组治疗后并发症发生率（13．3％）与对照组（16．7％）比较差异无统计学意义（P〉0．05）。结论高脂血症胰腺炎患者采用血浆置换疗法效果理想，值得推广应用。

Objective To observe the therapeutic effect of plasma exchange therapy in patients with hyperlipidemic pancreatitis and its effect on the levels of inflammatory factors. Methods 60 cases of hyperlipidemic pancreatitis were randomly divided into control group （n=30） and observation group （n=30）. Control group underwent traditional medical treatment, while observation group underwent plasma exchange therapy. Detected the levels of TNF-α, IL-2, IL-6, and IL-8 before and after treatment with enzyme-linked immunosorbent （ELISA）, compared clinical treatment effect and the levels of inflammatory factors of two groups. Results WBC, AMY, GLU, and blood lipid levels after treatment in observation group were lower than those in control group [（7.84±1.20）×10^9/L vs.（10.94±1.43）×10^9/L, （200.52±17.31）U/L vs.（425.12±20.64） U/L, （7.04±1.02）mmol/L vs.（9.04±2.51）mmol/L, （5.93±1.57）mmol/L vs.（10.49±4.26）mmol/L; P〈0.05], the levels of TNF-α, IL-2, IL-6, and IL-8 after treatment in observation group were lower than those in control group [（172.4±56.2）pg/ml vs.（246.7±96.4）pg/ml, （26.6±9.0）pg/ml vs.（41.4±11.1）pg/ml, （31.5±8.5）pg/ml vs.（134.4±37.8）pg/ml, （62.7±16.2）pg/ml vs.（149.5±28.3）pg/ml; P〈0.05], there was no statistically significant difference in the level of IL-10 between two groups before or after treatment [（24.6±15.3）pg/ml vs.（56.4±24.4） pg/ml, （116.7±34.6）pg/ml vs.（119.5±23.6）pg/ml; P〉0.05], there was no statistically significant difference in the incidence of complications between observation group and control group （13.3% vs.16.7%, P〉0.05）. Conclusion Plasma exchange therapy has ideal effect in patients with hyperlipidemic pancreatitis, worthy of popularization and application.