埃索美拉唑联合生长抑素对重症急性胰腺炎患者疗效及对胃肠功能和肠道黏膜屏障功能影响

Effect of esomeprazole combined with somatostatin on gastrointestinal function and gastrointestinal mucosal barrier function in patients with severe acute pancreatitis

目的:探讨埃索美拉唑联合生长抑素对重症急性胰腺炎(SAP)患者疗效及对胃肠功能和胃肠黏膜屏障功能的影响。方法:选择丽水市中心医院2017年1月至2019年12月收治的SAP患者68例为观察对象,按照随机表法分为观察组(34例)与对照组(34例)。对照组患者给予生长抑素治疗,观察组在对照组基础上联合埃索美拉唑治疗。两组疗程均为7 d。结果:观察组血淀粉酶恢复正常时间[(6.17±1.25)d]和发热消失时间[(4.03±0.76)d]均快于对照组[(7.87±1.02)d和(5.46±0.92)d](t=6.144、6.988,均P<0.05)。观察组治疗后胃肠功能评分[(1.29±0.18)分]和急性生理与慢性健康评分Ⅱ(APACHEⅡ)评分[(12.63±1.89)分]均低于对照组[(1.65±0.13)分和(16.32±2.19)分](t=9.454、7.438,均P<0.05)。观察组治疗后血清乳酸[(23.24±1.46)mmol/L]高于对照组[(19.20±2.10)mmol/L],而内毒素[(2.68±0.49)kU/L]低于对照组[(3.97±0.47)kU/L],均差异有统计学意义(t=9.210、11.078,均P<0.05)。观察组总有效率[91.18%(31/34)]高于对照组[67.65%(23/34)](χ^(2)=5.767,P<0.05)。结论:埃索美拉唑联合生长抑素对SAP患者疗效显著,且可改善患者胃肠功能和胃肠黏膜屏障功能。

Objective To investigate the effect of esomeprazole combined with somatostatin on gastrointestinal function and gastrointestinal mucosal barrier function in patients with severe acute pancreatitis.Methods Sixty-eight patients with severe acute pancreatitis who received treatment in Lishui Central Hospital from January 2017 to December 2019 were included in this study.They were randomly assigned to receive treatment with somatostatin(control group,n=34)or with somatostatin plus esomeprazole(observation group,n=34).Both groups were treated for 7 d.Results The recovery time of blood amylase and fever disappearance time in the observation group were significantly shorter compared with the control group[recovery time of blood amylase:(6.17±1.25)d vs.(7.87±1.02)d,t=6.144,P<0.05;fever disappearance time:(4.03±0.76)d vs.(5.46±0.92)d,t=6.988,P<0.05].After treatment,gastrointestinal function score in the observation group was significantly lower than that in the control group[(1.29±0.18)points vs.(1.65±0.13)points,t=9.454,P<0.05],and Acute Physiology And Chronic Health Evaluation(APACHE)-Ⅱscore in the observation group was significantly lower than that in the control group[(12.63±1.89)points vs.(16.32±2.19)points,t=7.438,P<0.05].After treatment,serum lactic acid level in the observation group was significantly higher than that in the control group[(23.24±1.46)mmol/L vs.(19.20±2.10)mmol/L,t=9.210,P<0.05].Serum endotoxin level in the observation group was significantly lower than that in the control group[(2.68±0.49)kU/L vs.(3.97±0.47)kU/L,t=11.078,P<0.05].Total effective rate in the observation group was significantly higher than that in the control group[91.18%(31/34)vs.67.65%(23/34),χ^(2)=5.767,P<0.05].Conclusion Esomeprazole combined with somatostatin is highly effective in the treatment of severe acute pancreatitis.and it can improve patient's gastrointestinal function and gastrointestinal mucosal barrier function.