乌司他丁联合埃索美拉唑治疗重症急性胰腺炎患者疗效观察及对患者肠道黏膜功能和炎性因子影响

Effect of ulinastatin combined with esomeprazole on intestinal mucosal function and inflammatory factor levels in patients with severe acute pancreatitis

目的:探讨乌司他丁联合埃索美拉唑治疗重症急性胰腺炎(SAP)患者疗效及对患者肠道黏膜功能和炎性因子影响。方法:选择嘉兴市第二医院2018年1月至2019年12月收治的SAP患者106例为观察对象,采用随机数字表法分为观察组(53例)与对照组(53例)。对照组患者给予埃索美拉唑治疗,观察组在对照组基础上给予乌司他丁治疗。两组疗程均为2周。比较两组治疗疗效,治疗前后胃肠功能恢复时间,肠道黏膜功能和炎性因子变化。结果:观察组总有效率[90.57%(48/53)]高于对照组[73.58%(39/53)](χ^(2)=5.194,P<0.05)。观察组胃肠功能恢复时间[(2.28±0.39)d]快于对照组[(4.35±0.61)d](t=20.814,P<0.05)。观察组治疗后血清内毒素[(0.38±0.10)ng/L]和D-乳酸[(5.46±0.84)mg/L]低于对照组[(0.82±0.27)ng/L、(8.65±1.23)mg/L](t=11.125、15.592,均P<0.05)。观察组治疗后血清超敏C反应蛋白[(23.15±6.57)mg/L]、白细胞介素8[(47.27±10.28)μg/L]和肿瘤坏死因子α[(64.72±13.26)ng/L]低于对照组[(47.83±12.15)mg/L、(68.52±7.89)μg/L、(92.35±18.97)ng/L](t=13.008、11.938、8.691,均P<0.05)。结论:乌司他丁联合埃索美拉唑治疗SAP患者疗效明显,可改善患者肠道黏膜功能,且可减轻炎性反应。

Objective To investigate the efficacy of ulinastatin combined with esomeprazole in the treatment of severe acute pancreatitis and its effect on intestinal mucosal function and inflammatory factor levles.Methods A total of 106 patients with severe acute pancreatitis who received treatment in Jiaxing Second Hospital from January 2018 to December 2019 were included in this study.They were randomly assigned to receive esomeprazole(control group,n=53)or ulinastatin combined with esomeprazole(observation group,n=53).Both groups were treated for 2 weeks.After treatment,curative effect,recovery time of gastrointestinal function,intestinal mucosal function and inflammatory factor levels were compared between the two groups.Results Total effective rate in the observation group was significantly higher than that in the control group[90.57%(48/53)vs.73.58%(39/53),χ^(2)=5.194,P<0.05).The recovery time of gastrointestinal function in the observation group was significantly shorter than that in the control group[(2.28±0.39)d vs.(4.35±0.61)d,t=20.814,P<0.05].Serum endotoxin and D-lactic acid levels in the observation group were significantly lower compared with the control group[endotoxin:(0.38±0.10)ng/L vs.(0.82±0.27)ng/L,t=11.125,P<0.05;D-lactic acid:(5.46±0.84)mg/L vs.(8.65±1.23)mg/L,t=15.592,P<0.05].After treatment,serum levels of CRP,interleukin-8 and tumor necrosis factor-αin the observation group were significantly lower than those in the control group[CRP:(23.15±6.57)mg/L vs.(47.83±12.15)mg/L,t=13.008,P<0.05;interleukin-8:(47.27±10.28)μg/L vs.(68.52±7.89)μg/L,t=11.938,P<0.05;tumor necrosis factor-α:(64.72±13.26)ng/L vs.(92.35±18.97)ng/L,t=8.691,P<0.05].Conclusion Ulinastatin combined with esomeprazole is effective in the treatment of severe acute pancreatitis,which can improve intestinal mucosal function and reduce inflammatory reactions.