生长抑素联合白蛋白治疗急性胰腺炎患者的效果及对胰腺功能和免疫功能的影响

Effect of Somatostatin Combined with Albumin on Patients with Acute Pancreatitis and Its Effects on Pancreatic Function and Immune Function

目的观察生长抑素联合白蛋白治疗急性胰腺炎(acute pancreatitis,AP)患者的效果及对胰腺功能和免疫功能的影响。方法回顾性分析采用生长抑素联合白蛋白治疗(观察组)及采用生长抑素治疗(对照组)的AP各38例的临床资料。观察比较两组临床症状消失时间,治疗后临床效果,治疗前后内皮功能、胰腺功能及免疫功能指标,以及治疗期间不良反应发生情况。结果观察组腹痛消失时间、腹胀消失时间和血清淀粉酶恢复正常时间均短于对照组,差异有统计学意义(P<0.01)。治疗后,观察组临床总有效率明显高于对照组,差异有统计学意义(P<0.05)。治疗前,两组内皮功能、胰腺功能及免疫功能指标比较差异均无统计学意义(P>0.05)。治疗后,两组血清内皮素(ET)、血栓素B 2(TXB 2)水平和胰腺组织毛细血管表面通透性(PS)较治疗前降低;血清6-酮-前列腺素F1α(6-keto-PGF1α)水平,胰腺组织血流量(BF)、血容量(BV),以及外周血T淋巴细胞亚群CD3+、CD4+水平,CD4+/CD8+值较治疗前升高,差异有统计学意义(P<0.01)。治疗后,观察组血清ET、TXB 2水平和胰腺组织PS低于对照组;血清6-keto-PGF1α水平,胰腺组织BF、BV,以及外周血T淋巴细胞亚群CD3+、CD4+水平,CD4+/CD8+值高于对照组,差异有统计学意义(P<0.05或P<0.01)。治疗期间,两组低血糖、恶心、呕吐、腹部绞痛及总不良反应发生率比较差异均无统计学意义(P>0.05)。结论生长抑素联合白蛋白治疗AP效果显著,可改善内皮功能、胰腺功能和免疫功能,使患者临床症状尽早缓解。

Objective To observe the effect of Somatostatin combined with Albumin on patients with acute pancreatitis(AP)and its effects on pancreatic function and immune function.Methods The clinical data of each 38 patients with AP who received Somatostatin combined with Albumin(observation group)or Somatostatin(control group)were retrospectively analyzed.The disappearance time of clinical symptoms,clinical efficacy after treatment,as well as indexes of endothelial function,pancreatic function and cellular immune function before and after treatment and occurrence of adverse reactions during treatment were observed and compared between the two groups.Results The disappearance time of abdominal pain,disappearance time of abdominal distension and normal recovery time of serum amylase in observation group were shorter than those in control group(P<0.01).After treatment,the total effective rate in observation group was significantly higher than that in control group(P<0.05).Before treatment,there were no significant differences in the indexes of endothelial function,pancreatic function and immune function between the two groups(P>0.05).After treatment,the levels of serum endothelin(ET)and thromboxane B 2(TXB 2)and pancreatic tissue capillary permeability surface(PS)in the two groups were decreased compared with those before treatment while the 6-keto-prostaglandin F1α(6-kheto-PGF1α),pancreatic tissue blood flow(BF),blood volume(BV)and peripheral blood T lymphocyte subsets CD3+,CD4+and CD4+/CD8+were increased compared with those before treatment(P<0.01).After treatment,the levels of serum ET and TXB 2 and pancreatic tissue PS in observation group were lower than those in control group while the levels of serum 6-keto-pGF1,pancreatic tissue BF,BV and peripheral blood T lymphocyte subsets CD3+,CD4+and CD4+/CD8+were higher than those in control group(P<0.05 or P<0.01).During treatment,there were no statistically significant differences in the incidence rates of hypoglycemia,nausea,vomiting and abdominal cramps and total incidence rate of adverse reactions between the two groups(P>0.05).Conclusion Somatostatin combined with Albumin has a significant efficacy on AP,and it can improve endothelial function,pancreatic function and immune function,and relieve the clinical symptoms of patients as soon as possible.