异甘草酸镁联合奥曲肽治疗急性重症胰腺炎疗效及对患者血清sTREM-1和sB7-H2表达影响

Effect of Isoglycyrrhizinate Combined with Octreotide in the Treatment of Acute Severe Pancreatitis and Its Effect on the Expression of Serum Strem-1 and SB7-H2 in Patients

目的:观察异甘草酸镁联合奥曲肽治疗急性重症胰腺炎的疗效,及对患者血清可溶性髓系细胞触发受体-1(sTREM-1)和可溶性B7-H2(sB7-H2)表达的影响。方法:急性重症胰腺炎患者90例随机分为观察组与对照组,每组45例。对照组给予奥曲肽治疗,观察组给予奥曲肽联合异甘草酸镁治疗。治疗3周后观察两组疗效、死亡率和药品不良反应发生率,比较两组患者治疗前后血清炎症因子(TNF-α、IL-6、IL-10)、sTREM-1、sB7-H2、生化指标(淀粉酶、LDH、Alb)和免疫球蛋白(IgG、IgA、IgM)水平变化。结果:观察组有效率为86.67%,明显高于对照组的62.22%(P<0.05)。治疗后,两组患者血清IgG、IgA、IgM,IL-10和Alb水平均较前明显升高,血清TNF-α、IL-6、淀粉酶、LDH、sTREM-1和sB7-H2水平则较前明显下降(P<0.05);且观察组各项指标均明显优于对照组(P<0.05)。两组药品不良反应发生率和死亡率比较差异无统计学意义(P>0.05)。结论:异甘草酸镁联合奥曲肽治疗急性重症胰腺炎能显著提高疗效,减轻炎症反应,减少胰酶分泌,调节免疫,具有一定临床价值。

Objective:To observe the effect of isoglycyrrhizinate combined with octreotide in the treatment of acute severe pancreatitis and its effect on the expression of serum Strem-1 and SB7-H2 in patients. Methods:Totally 90 patients with severe acute pancreatitis were randomly divided into observation group and control group, 45 cases in each group. The control group was treated with octreotide, and the observation group was treated with octreotide and magnesium isoglycyrrhizinate. The therapeutic effect, mortality rate, adverse drug reaction was observed after 3 weeks treatment. The changes of TNF-α, IL-6, IL-10, sTREM-1, sB7-H2, amylase, LDH, Alb, IgG, IgA, IgM were compared between the two groups before and after treatment. Results: The effective rate of the observation group was 86.67%, which was significantly higher than 62.22% of the control group(P<0.05). After treatment, the levels of serum IgG, IgA, IgM, IL-10 and Alb in the two groups were higher than before, while the levels of TNF-α, IL-6, amylase, LDH, sTREM-1 and sB7-H2 were significantly lower than before(P<0.05). The indexes of the observation group were obviously better than those of the control group(P<0.05). There were no significant differences in the adverse drug reaction and mortality rate of the two groups(P<0.05). Conclusion:Magnesium isoglycyrrhizinate combined with octreotide could improve the clinical symptoms of patients with acute severe pancreatitis, improve the therapeutic effect, reduce the inflammatory response, reduce the secretion of pancreatin, regulate the immune system, which has a certain clinical value.