胰岛素强化联合乌司他汀对中重度急性胰腺炎的近期疗效观察

Study on the short-term effect of intensive insulin therapy combined with ulinastatin in treatment of moderate to severe acute pancreatitis

目的探讨强化胰岛素联合乌司他汀对中重度急性胰腺炎的临床疗效。方法突发中重度急性胰腺炎病人70例,按照治疗方案的不同随机分为两组,每组各35例。对照组采用急性胰腺炎常规治疗+乌司他汀治疗,联合组在对照组治疗的基础上加用胰岛素强化治疗,比较两组病人住院时间,治疗前、治疗后第3天、7天的APACHE-Ⅱ评分、全血白细胞、红细胞、血小板数量、肝肾功能、白细胞介素(IL)-6以及超敏C-反应蛋白(hs-CRP)的变化情况。结果对照组住院时间为(21.8±13.2)天,第3天、第7天APACHE-Ⅱ评分为(10.5±4.3)、(8.3±3.1),联合组住院时间为(18.9±14.4)天,第3天,第7天APACHE-Ⅱ评分为(8.7±3.2)和(5.7±2.9),两组比较差异有统计学意义(P<0.05)。两组病人入院后第3天和第7天血液中白细胞数量、血清中IL-6、hs-CRP,丙氨酸氨基转移酶、血肌酐与治疗前比较,差异均有统计学意义(P<0.05)。结论胰岛素强化联合乌司他汀可改善中重度急性胰腺炎病人住院治疗的近期疗效。

Objective To explore the clinical effect of intensive insulin therapy combined with ulinastatin in treatment of moderate to severe acute pancreatitis. Methods 70 patients were chosen due to sudden severe acute pancreatitis and received inpatient treatment,they were randomly divided into two groups（ 35 cases each） according to the different treatment,the control group received conventional treatment of acute pancreatitis combined with ulinastatin,combination group were based on the treatment of control group combined with intensive insulin therapy,analysing data between the two groups of patients in hospital time,,the third and seventh day of the APACHE-score before and after the treatment,white blood cells,red blood cell,platelet count,blood glucose,liver and kidney function,IL-6 and high sensitivity Creactive protein（ hs-CRP） changes. Results The time of hospitalization in the control group was（ 21. 8 ±13. 2） days,the score of APACHE II in the third day and seventh day were（ 10. 5 ± 4. 3） and（ 8. 3 ±3. 1）. The hospitalization time of the combined group was（ 18. 9 ± 14. 4） days and the third days,and the seventh days of APACHE II score were（ 8. 7 ± 3. 2） and（ 5. 7 ± 2. 9）（ P〈0. 05）. The number of blood white blood cells,serum IL-6,hsC RP,alanine aminotransferase and serum creatinine between the two groups were also statistically significant after third and seventh days of admission（ P〈0. 05）. Conclusion Intensive insulin therapy combined with ulinastatin can significantly improve the short-term effect of inpatient treatment in patients with moderate to severe acute pancreatitis.