前列地尔联合生长抑素对急性胰腺炎患者近期疗效、病程及实验室指标的影响

Effect of alprostadil combined with somatostatin on short-term curative effect, course of disease and laboratory indexes in patients with acute pancreatitis

目的研究前列地尔联合生长抑素双联药物方案对急性胰腺炎(AP)患者近期疗效、病程及实验室指标的影响。方法选择2016年1月至2017年12月接受治疗的AP患者130例,用随机数字表法分为对照组和观察组,每组各65例。对照组患者在常规治疗的基础上予生长抑素6 mg+生理盐水48 mL,应用微量泵通过静脉持续泵入,速率为生长抑素250μg·h-1;观察组患者在对照组治疗的基础上加用前列地尔20μg+生理盐水100 mL,iv gtt,qd。比较2组患者的临床疗效、症状恢复时间和炎性因子水平等。结果观察组患者总有效率为95.38%,明显高于对照组的80.00%(P<0.05)。治疗后2组患者的TNF-a、IL-6、hs-CRP和内毒素水平均较治疗前明显下降,且观察组患者的炎性因子和内毒素水平均低于对照组(P<0.05)。观察组患者的腹痛持续时间、腹膜炎体征消失时间、胃肠功能恢复时间和住院时间均短于对照组(P<0.05)。治疗后2组患者的血清淀粉酶水平均较治疗前明显下降,且观察组患者治疗后第3、5、7天的血清淀粉酶水平均低于对照组(P<0.05)。结论前列地尔联合生长抑素可以明显提高AP患者的近期疗效,缩短患者的临床症状恢复时间,降低患者的炎性因子、内毒素和血清淀粉酶水平,有利于患者康复。

AIM To study the effect of alprostadil combined with somatostatin on the short-term efficacy, the course of disease and the laboratory indexes in patients with acute pancreatitis(AP) patients. METHODS A total of 130 AP patients who were treated in our hospital from January 2016 to December 2017 were divided into control group and observation group randomly, with 65 patients in each group. The patients in the control group were given somatostatin on the basis of routine treatment, and 6 mg somatostatin was added into 48 mL physiological saline through intravenous continuous pump. The patients in the observation group were given alprostadil on the basis of the treatment of control group, and 20 μg alprostadil was added into 100 mL physiological saline for intravenous drip, qd. The clinical efficacy, symptom recovery time and inflammatory factors were compared between 2 groups. RESULTS The total effective rate of the observation group was 95.38%, which was significantly higher than 80% of the control group(P<0.05). After treatment, the levels of TNF-α, IL-6, hs-CRP and endotoxin in the 2 groups were significantly decreased than those before treatment, while the levels of inflammatory factors and endotoxin in the observation group were lower than those in the control group(P<0.05). The duration of abdominal pain, the disappearance time of the signs of peritonitis, the recovery time of gastrointestinal function and the time of hospitalization in the observation group were shorter than those in the control group(P<0.05). After treatment, the serum amylase levels of the 2 groups decreased significantly than those before treatment, and the serum amylase(AMS) levels in the observation group were lower than those in the control group on the 3 rd, 5 th and 7 th day after treatment(P<0.05). CONCLUSION Alprostadil combined with somatostatin can significantly improve the curative effect of AP patients, shorten the recovery time of patients, and reduce the levels of inflammatory factors and endotoxin and AMS, which is conducive to the rehabilitation of patients.