乌司他丁联合谷氨酰胺对重症急性胰腺炎相关性肺损伤的防治作用

Preventive and remedial effect of ulinastatin combined with glutamine on the acute pancreatitis associated lung injury

目的探讨乌司他丁联合谷氨酰胺在治疗重症急性胰腺炎(severe acute pancreatitis,SAP)时对急性胰腺炎相关性肺损伤(acute pancreatitis associated lung injury,APALI)的预防和治疗作用。方法我院收治的60例SAP患者随机分为两组,对照组30例行常规+乌司他丁治疗;研究组30例在对照组基础上加用谷氨酰胺治疗。分别于治疗后第0,3,7,10天分析患者动脉血气,以血Pa O_2与吸氧浓度比值(Pa O_2/Fi O_2)、呼吸频率和肺部X线检查等为观察指标,同时抽取静脉血以检测患者血清TNF-α、IL-8及DAO水平的变化,观察研究组和对照组之间肺损伤发生率和对肺损伤疗效的差异。结果研究组APALI的发生率为33.3%,对照组为57.1%,两者差异有统计学意义(P<0.05);治疗7 d后,研究组肺损伤程度较对照组显著减轻,且血清中TNF-α、IL-8及DAO的数值较对照组明显下降(P<0.05)。结论乌司他丁联合谷氨酰胺在治疗SAP时具有协同作用,对急性胰腺炎相关性肺损伤有显著预防和治疗作用。

Objective To study the preventive and remedial effects of ulinastatin(UST)combined withglutamine(GLN)on the severe acute pancreatitis(SAP)patients with acute lung injury(ALI).Methods In ourhospital,60cases of SAP patients were randomly divided into two groups,30cases in the control group wereperformed conventional+ulinastatin treatment;another30patients in the study group received additional glutaminetreatment.The difference of lung injury incidence and curative effect on lung injury between two groupswere analyzed by monitoring PaO2,PaO2/FiO2,respiratory frequency and lung X-rays,while venous blood wasextracted to detect serum TNF-α,IL-8and DAO levels.Results The incidence of APALI was33.3%in the studygroup and57.1%in the control group,there was significant difference between two groups(P<0.05).Seven dayafter treatment,the degree of lung injury in the study group was significantly reduced than that in the controlgroup,and serum TNF-α,IL-8and DAO values were decreased significantly than those in the control group(P<0.05).Conclusion UST combined with GLN has a synergetic treatment effect on SAP,and this treatment hassignificant preventive and remedial effects on APALI.