丹红注射液联合前列腺素E对急性胰腺炎患者微循环的影响

Effect of Danhong injection combined with prostaglandin E on microcirculation in patients with acute pancreatitis

目的探讨丹红注射液联合前列腺素E对急性胰腺炎患者微循环的影响。方法选取急性胰腺炎患者70例,随机分为观察组、对照组各35例,对照组给予常规治疗,观察组辅以丹红注射液+前列腺素E,对比2组治疗前后总血管密度(TVD)、灌注血管密度(PVD)、灌注血管比例(PPV)、微血管流动指数(MFI),记录其腹部症状消失时间、急性生理与慢性健康评分(APACHEⅡ评分)、血清淀粉酶、D-二聚体(D-D)、纤维蛋白原(FIB)水平变化,比较2组内皮素(ET)、前列腺素I2(PGI2)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)水平。结果观察组治疗后PVD、PPV、MFI均显著高于对照组(P<0.05);观察组治疗后腹部症状消失时间短于对照组,APACHEⅡ评分、血清淀粉酶、D-D、FIB显著低于对照组(P<0.05);治疗后观察组血清ET、TNF-α、IL-6、hs-CRP显著低于对照组,而PGI2较对照组显著增加(P<0.05);治疗后观察组中转手术率、不良反应发生率显著低于对照组(P<0.05)。结论丹红注射液联合前列腺素E辅助治疗急性胰腺炎可明显改善患者微循环及内皮功能、凝血功能,降低炎症因子水平,改善预后。

Objective To investigate the effect of Danhong injection combined with prostaglandin E on microcirculation in patients with acute pancreatitis(AP).Methods A total of 70 patients with AP admitted to our hospital were enrolled in the study and were randomly divided into observation group and control group,with 35 cases in each group.The control group was given conventional treatment,while the observation group were additionally treated with Danhong injection and prostaglandin E.The total vascular density(TVD),perfusion vessel density(PVD),the proportion of perfusion vessels(PPV) and microvascular flow index(MFI) were compared between the two groups before and after treatment.The time of abdominal symptoms disappearing,acute physiology and chronic health score(APACHE Ⅱ score),serum amylase,D-dimer(D-D) and fibrinogen(FIB) levels were recorded.Levels of endothelin(ET),prostaglandin I2(PGI2),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6) and high-sensitivity C reactive protein(hs-CRP) were compared between the two groups and the prognosis was recorded.Results After treatment,the PVD,PPV and MFI of observation group were significantly higher than those of the control group(P < 0.05).The disappearing time of abdominal symptoms in observation group after treatment was shorter than that in the control group,and APACHE Ⅱ score,levels of serum amylase,D-D and FIB were lower than those in the control group(P < 0.05).After treatment,the levels of serum ET,TNF-α,IL-6 and hs-CRP in observation group were lower than those in the control group,and PGI2 level was higher than that in the control group(P < 0.05).After treatment,the rate of conversion to operation and the incidence of adverse reactions in the observation group were lower than those in the control group(P < 0.05).Conclusion The application of Danhong injection combined with prostaglandin E in the treatment of AP can significantly improve the microcirculation,endothelial function and coagulation function,reduce the levels of inflammatory factors and improve the prognosis.