生长抑素联合质子泵抑制剂治疗重症胰腺炎患者的疗效及对其二胺氧化酶、D-乳糖水平变化的影响

Effect of somatostatin combined with proton pump inhibitor on severe acute pancreatitis and its effect on diamine oxidase and D-lactose

目的探讨生长抑素联合质子泵抑制剂治疗重症胰腺炎(SAP)患者的疗效及对其二胺氧化酶、D-乳糖水平变化的影响。方法选取2014年5月—2016年4月中国人民解放军第152中心医院64例SAP患者,通过随机数字表法分组,各32例。对照组采用常规治疗,研究组在常规治疗基础上给予生长抑素联合质子泵抑制剂治疗,两组均持续治疗7 d。统计对比两组临床疗效、不良反应发生率,分析入院时及疗程结束后两组D-乳糖与二胺氧化酶水平变化情况。结果研究组治疗有效率90.62%(29/32)高于对照组68.75%(22/32),差异有统计学意义(P<0.05);治疗前两组腹内高压、D-乳糖与二胺氧化酶水平比较,差异无统计学意义(P>0.05),治疗后两组各指标水平均较治疗前降低,且研究组腹内高压、D-乳糖与二胺氧化酶水平低于对照组,差异有统计学意义(P<0.05);治疗前两组IL-8及TNF-α水平比较,差异无统计学意义(P>0.05),治疗后两组各指标水平均较治疗前降低,且研究组IL-8及TNF-α水平低于对照组,差异有统计学意义(P<0.05);研究组不良反应发生率15.64%(5/32)与对照组21.88%(7/32)比较,差异无统计学意义(P>0.05)。结论重症胰腺炎患者联合采用生长抑素及质子泵抑制剂疗效显著,可减少临床症状缓解时间,降低二胺氧化酶、D-乳糖、腹内高压、血清炎症因子水平,且安全性较高,值得推广。

Objective To investigate the effect of somatostatin combined with proton pump inhibitor in the treatment of severe acute pancreatitis（ SAP） and its effect on the changes of diamine oxidase and D-lactose. Methods From May2014 to April 2016,64 patients with SAP in Chinese People＇s Liberation Army 152 Center Hospital were randomly divided into control group and study group,each group 32 cases. The control group was treated with routine treatment,and the study group was treated with somatostatin combined with proton pump inhibitor on the basis of routine treatment,both groups were treated for 7 days. Clinical symptoms improved time,clinical efficacy,the incidence of adverse reactions were statistically compared between the two groups,D-lactose and diamine oxidase and serum inflammatory factors [interleukin-8（ IL-8） and tumor necrosis factor-α（ TNF-α） ]levels were analyzed at the time of admission and after treatment. Results The Urine amylase and serum amylase levels,normal bowel function recovery time,abdomen abdominal pain disappeared time and hospitalization time in the study group were significantly lower than those in the control group（ P〈 0. 05）; The effective rate in the study group 90. 62%（ 29/32） was significantly higher than those in the control group 68. 75%（ 22/32）（ P〈 0. 05）; There was no significant difference in the levels of intraperitoneal hypertension,D-lactose and diamine oxidase between the two groups before treatment（ P〈 0. 05）,but after treatment,each indicator levels were significantly lower than before treatment,and the intra-abdominal hypertension,D-lactose and diamine oxidase levels in the study group were significantly lower than the control group（ P〈 0. 05）; There was no significant difference in IL-8 and TNF-α levels between the two groups before treatment（ P〈 0. 05）,but after treatment,each indicator levels were significantly lower than before treatment,and the study group were significantly lower than those in the control group（ P〈 0. 05）; There was no significant difference in the incidence of adverse reactions between the study group（ 15. 64%,5/32） and 21. 88%（ 7/32） in the control group（ P〈 0. 05）. Conclusion Treatment of Severe acute pancreatitis using somatostatin combined with proton pump inhibitor gets good effect,which can reduce clinical symptoms remission time,reduce the diamine oxidase,D-lactose,intra-abdominal hypertension and serum inflammatory factors levels,and the safety is high,worthy of promotion.