CRRT治疗重症胰腺炎的疗效及对患者胰腺微循环指标和血清Ghrelin PCT水平的影响

Efficacy of CRRT on Severe Pancreatitis and Its Influence on Pancreatic Microcirculation Indexes and Serum Ghrelin and PCT Levels

目的: 分析连续性肾脏疗法(CRRT)治疗重症胰腺炎的疗效及对患者胰腺微循环指标和血清血清生长素(Ghrelin)、降钙素原(PCT)水平的影响。 方法: 回顾性分析我院经CRRT治疗(观察组)及经常规治疗(对照组)的重症胰腺炎患者各102例临床资料。记录两组临床指标缓解时间,并比较两组治疗前及治疗3d后胰腺微循环指标[胰腺血流量(BF)、血流容积(BV)]、血清学指标[Ghrelin、PCT、血栓素A2(TXA2)]及急性生理和慢性健康状况(APACHEII)、Balthazar 电子计算机断层扫描(CT)严重度指数(CTSI)评分差异。 结果: 观察组血清淀粉酶恢复、肠鸣音恢复、腹痛缓解、腹胀缓解时间均低于对照组(P<0.05)。治疗3d后,两组胰腺微循环指标(胰腺BF、BV)均较治疗前升高(P<0.05),且观察组高于对照组(P<0.05);两组血清学指标(血清Ghrelin、PCT、TXA2)、APACHE II、CTSI评分均较治疗前降低(P<0.05),且观察组均低于对照组(P<0.05)。 结论: CRRT疗法治疗重症胰腺炎效果显著,不仅能促进患者症状缓解,也能减轻胰腺微循环障碍,于患者病情转归有积极意义。

Objective: To analyze the efficacy of continuous renal replacement therapy (CRRT) in the treatment of severe pancreatitis and its influence on pancreatic microcirculation indexes and serum Ghrelin and procalcitonin (PCT) levels. Methods: The clinical data of each 102 patients with severe pancreatitis treated by CRRT (observation group) and conventional treatment (control group) were retrospectively analyzed. The times of clinical indexes remission were recorded in the two groups, and pancreatic microcirculation indexes [pancreatic blood flow (BF), blood flow volume (BV)], serological markers [Ghrelin, PCT, thromboxane A2 (TXA2)] and acute physiology and chronic health evaluation (APACHE II), and Balthazar computed tomography (CT) severity index (CTSI) were compared between the two groups before treatment and after 3d of treatment. Results: The recovery time of serum amylase, bowel sounds, abdominal pain remission and abdominal distension remission in observation group were lower than those in control group (P<0.05). After 3d of treatment, the pancreatic microcirculation indexes (pancreatic BF, BV) in the two groups were increased compared with those before treatment (P<0.05), and the indexes in observation group were higher than those in control group (P<0.05). Serological markers (serum Ghrelin, The PCT, TXA2) and scores of APACHE II and CTSI in the two groups were decreased compared with those before treatment (P<0.05), and the markers and scores in observation group were lower than those in control group (P<0.05). Conclusions: CRRT therapy has significant effects in the treatment of severe pancreatitis. And it can not only promote the relief of symptoms, but also relieve the pancreatic microcirculation disorder, and it has positive significance in disease outcomes of patients.