DCRRT联合血浆置换对非胆源性重症急性胰腺炎患者血脂肪酶和淀粉酶及炎症因子的影响

Effect of DCRRT Combined with Plasma Exchange on Blood Lipase and Amylase and Inflammatory Factors in Patients with Non-biliary Severe Acute Pancreatitis

目的探讨连续性血液净化(DCRRT)联合血浆置换对非胆源性重症急性胰腺炎患者血脂肪酶和淀粉酶及炎症因子的影响。方法选取2020年1月至2021年1月在本院确诊的98例非胆源性重症急性胰腺炎患者,采用简单随机分组将患者分为观察组和对照组,每组各49例。对照组患者采用DCRRT治疗,观察组采用DCRRT联合血浆置换治疗,每次治疗8 h。分别于治疗前后,采用全自动生化分析仪检测血淀粉和脂肪酶水平,ELISA法检测两组患者炎症因子水平包括白介素6(IL-6)、肿瘤坏死因子α(TNF-α)。记录两组治疗期间的不良反应发生情况。结果治疗后,与治疗前相比较两组患者血淀粉和脂肪酶水平均显著降低,且观察组明显低于对照组,差异具有统计学意义(P<0.05);治疗后,与治疗前相比较两组患者IL-6、TNF-α水平均显著降低,且观察组明显低于对照组,差异具有统计学意义(P<0.05)。对照组总不良反应发生率12.24%;观察组总不良反应发生率14.29%。两组总不良反应发生率差异无统计学意义(χ^(2)=0.089,P=0.766)。结论DCRRT联合血浆置换可以显著降低非胆源性重症急性胰腺炎患者血脂肪酶和淀粉酶以及炎症因子。

Objective To investigate the effect of continuous blood purification(DCRRT)combined with plasma exchange on blood lipase,amylase and inflammatory factors in patients with non-biliary severe acute pancreatitis.Methods A total of 98 patients with non-biliary severe acute pancreatitis diagnosed in our hospital from January 2020 to January 2021 were selected.The patients were divided into observation group and control group by simple random grouping,with 49 cases in each group.Patients in the control group were treated with DCRRT,and the observation group was treated with DCRRT combined with plasma exchange treatment for 8 hours each time.Before and after treatment,blood starch and lipase levels were detected by an automatic biochemical analyzer,and the levels of inflammatory factors including interleukin 6(IL-6)and tumor necrosis factorα(TNF-α)were detected by ELISA.The occurrence of adverse reactions during the treatment of the two groups was recorded.Results After treatment,compared with before treatment,the blood starch and lipase levels of the two groups were significantly reduced,and the observation group was significantly lower than the control group,the difference was statistically significant(P<0.05);after treatment,compared with before treatment The levels of IL-6 and TNF-αof the two groups of patients were significantly reduced,and the observation group was significantly lower than the control group,the difference was statistically significant(P<0.05).The total incidence of adverse reactions in the control group was 12.24%;the total incidence of adverse reactions in the observation group was 14.29%.There was no significant difference in the incidence of total adverse reactions between the two groups(χ^(2)=0.089,P=0.766).Conclusion DCRRT combined with plasma exchange can significantly reduce blood lipase,amylase and inflammatory factors in patients with non-biliary severe acute pancreatitis.