乌司他丁治疗急性重症胰腺炎的效果及对血清炎症因子水平的影响

Clinical efficacy of ulinastatin on severe acute pancreatitis and its effect on serum levels of inflammatory cytokines

目的观察乌司他丁治疗急性重症胰腺炎的效果及血清炎症因子的变化情况。方法选择急性重症胰腺炎患者86例，随机分为对照组和观察组，每组43例。对照组给予常规治疗，观察组在常规治疗的基础上加用乌司他丁，治疗后7 d，观察两组患者的急性生理学及慢性健康状况（APACHEⅡ）评分、临床症状消失时间以及血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）水平。结果治疗后7 d，观察组患者的APACHEⅡ评分为（8.93±2.47）分，明显低于对照组的（11.61±2.58）分（P〈0.01）；观察组患者腹痛、腹胀及恶心呕吐等临床症状的消失时间均明显短于对照组（P〈0.01）；两组患者治疗后TNF-α、IL-6及IL-8水平均明显降低（P〈0.01），且观察组治疗后各炎症因子水平均明显低于对照组（P〈0.01）。结论采用乌司他丁治疗急性重症胰腺炎，能够迅速改善患者临床症状，降低血清炎症因子水平，临床效果显著。

Objective To observe the effect of alinastatin on the treatment of severe acute pancreatitis and level of the serum inflammatory factors.Methods Eighty-six patients with severe acute pancreatitis were randomly divided into observation group and control group, with 43 cases in each group. The control group was given common treatment, the observation group underwent the conventional treatment combined with ulinastatin. Acute physiology and chronic health evaluation （APACHEⅡ）, clinical symptoms disappeared time, serum tumor necrosis factor-α（TNF-α）, interleukin-6（IL-6） and interleukin-8（IL-8） were compared between two groups after 7 d of treatment.Results After 7 d of treatment, the APACHE Ⅱ score of observation group was 8.93±2.47, which was significantly lower than that of control group （11.61±2.58, P〈0.01）. The disappearing time of abdominal pain, bloating, nausea, vomiting and other clinical symptoms in observation group were shorter than those in control group. The levels of TNF-α, IL-6 and IL-8 in the two groups after treatment significantly decreased （P〈0.01）, and the levels of all inflammatory factors in observation group were significantly lower than those in control group after treatment （P〈0.01）.Conclusions Ulinastatin in the treatment of severe acute pancreatitis can rapidly improve the clinical symptoms, reduce levels of serum inflammatory factors, with significant clinical effect.