乌司他丁联合血液净化对急性胰腺炎患者血清TNF-α、IL-1β和IL-6的影响

Effects of ulinastatin combined with blood purification on the serum levels of TNF-α,IL-1β,IL-6 in patients with acute pancreatitis

目的探讨乌司他丁联合血液净化对急性胰腺炎患者血清TNF-α、IL-1β和IL-6的影响。方法选择2015年1~12月就诊的90例急性胰腺炎患者作为研究对象,将其随机分为观察组和对照组,每组45例。观察组采用乌司他丁联合血液净化治疗方法,对照组采用常规治疗方法,比较2组患者临床症状体征恢复时间、血淀粉酶以及肝肾功能、血清TNF-α、IL-1β和IL-6水平差异。结果观察组接受治疗后的腹胀、腹痛、恶心呕吐、腹膜刺激征等体征恢复时间分别为(2.32±0.29)、(1.71±0.26)、(2.21±0.34)、(1.86±0.25)d,对照组分别为(4.16±0.54)、(3.43±0.76)、(3.78±0.32)、(4.22±0.39)d,观察组明显少于对照组,差异有统计学意义(P<0.05)。治疗后观察组和对照组AMY、ALT、Cr较治疗前均有所降低,但观察组AMY、ALT、Cr[(0.59±0.11)U/L、(35.87±0.12)U/L、(35.94±2.32)μmol/L)]降低幅度明显大于对照组[(1.23±0.17)U/L、(87.24±5.66)U/L、(87.43±5.81)μmol/L)],差异有统计学意义(P<0.05)。治疗后观察组和对照组TNF-α、IL-1β、IL-6水平较治疗前均有所降低,但观察组TNF-α、IL-1β、IL-6水平[(212.99±20.74)ng/L、(11.86±2.11)ng/L、(30.52±3.35)ng/L]降低幅度显著大于对照组[(348.93±32.14)ng/L、(16.77±2.94)ng/L、(48.13±5.69)ng/L)],差异有统计学意义(P<0.05)。结论乌司他丁联合血液净化能够降低患者血淀粉酶及改善肝肾功能,优化患者血清TNF-α、IL-1β和IL-6水平,加快患者康复。

Objective To investigate the effects of ulinastatin combined with blood purification on the serum levels of TNF-α,IL-1β,IL-6 in patients with acute pancreatitis .Methods Ninety patients with acute pancreatitis who were treated in our hospital from January 2015 to December 2015 were randomly divided into observation group and control group , with 45 patients in each group.The patients in observation group were treated by ulinastatin combined with blood purification , however ,the patients in control group were treated by conventional therapy .The recovery time of clinical symptoms , serum amylase levels,liver and kidney function ,serum levels of TNF-α,IL-1βand IL-6 were detected and compared between two groups.Results The recovery time of abdominal pain ,nausea,vomiting, peritoneal irritation sign in observation group after treatment was （2.32 ±0.29）d,（1.71 ±0.26）d,（2.21 ±0.34）d,respectively,however,which in control group was （4.16 ± 0.54）d,（3.43 ±0.76）d,（3.78 ±0.32）d,（4.22 ±0.39）d,respectively,which in observation group was significantly less than that in control group （ P 〈0.05）.After treatment the levels of AMY,ALT,Cr in both groups were decreased,as compared with those before treatment ,however , the decrease extent in observation group was more obvious than that in control group [（0.59 ±0.11）U/L,（35.87 ±0.12）U/L,（35.94 ±2.32）μmol/L）]vs [（1.23 ±0.17）U/L,（87.24 ±5.66）U/L, （87.43 ±5.81）μmol/L）] （ P 〈0.05）.After treatment the serum levels of TNF-α,IL-1β,IL-6 in both groups were decreased ,as compared with those before treatment ,but the decrease extent in observation group was more obvious than that in control group [（212.99 ±20.74）ng/L,（11.86 ±2.11）ng/L, （30.52 ±3.35）ng/L）]vs[（348.93 ±32.14）ng/L,（16.77 ± 2.94）ng/L,（48.13 ±5.69） ng/L）] （ P 〈0.05）.Conclusion The ulinastatin combined with blood purification can decrease the serum levels of amylase and can improve liver and kidney function , and optimize the serum levels of TNF-α, IL-1β, IL-6 to promote rehabilitation of patients with acute pancreatitis .