血必净联合生长抑素对重症急性胰腺炎患者炎症因子及预后的改善作用

Effect of Xuebijing combined with somatostatin on inflammatory factors and prognosis in patients with severe acute pancreatitis

目的:探究血必净联合生长抑素对重症急性胰腺炎(severe acute pancreatitis,SAP)患者炎症因子及预后的改善作用。方法:选取2018年1月至2021年3月安徽省第二人民医院收治的108例SAP患者为研究对象,随机分为对照组和观察组,每组54例。对照组予以生长抑素治疗,观察组予以血必净联合生长抑素治疗。比较两组临床体征或症状消失时间及治疗前和治疗后2、5、10 d时血清淀粉酶(amylase,AMS)、血清脂肪酶(lipase,LPS)、尿淀粉酶(amylase,UAMY)及炎症因子C反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)、白细胞计数(white blood cell,WBC)水平,并比较两组并发症发生率及病死率。结果:观察组腹膜刺激征、恶心呕吐、腹胀、腹痛等临床体征恢复时间均短于对照组(均P<0.05)。与对照组相比,观察组治疗2、5、10 d后的AMS、LPS、UAMY及血清CRP、PCT、WBC水平均显著降低(P<0.05)。观察组并发症发生率为11.11%,明显低于对照组的27.78%(P<0.05);两组病死率比较差异无统计学意义(P>0.05)。结论:血必净联合生长抑素可有效促进SAP患者临床症状的消失,抑制胰酶释放和炎症反应,降低并发症发生率,改善预后。

Objective:To explore the improvement effect of Xuebijing combined with somatostatin on inflammatory factors and prognosis in patients with severe acute pancreatitis(SAP).Methods:A total of 108 SAP patients admitted to our hospital from January 2018 to March 2021 were selected as the research subjects and randomly divided into a control group and an observation group,with 54 cases in each group.The control group was treated with somatostatin,and the observation group was treated with Xuebijing combined with somatostatin.The recovery time of clinical signs or symptoms,serum amylase(AMS),serum lipase(LPS),urine amylase(UAMY),inflammatory factor C-reactive protein(CRP),procalcitonin(PCT),and white blood cell(WBC)count before and 2,5,10 d after the treatment were compared between the 2 groups,and the incidence of complications and mortality were compared between the 2 groups.Results:The recovery time of clinical signs such as peritoneal irritation,nausea and vomiting,abdominal distension and abdominal pain in the observation group was shorter than that in the control group(P<0.05).Compared with the control group,the levels of AMS,LPS,UAMY water,and serum CRP,PCT and WBC in the observation group were significantly lower 2,5,10 d after the treatment(P<0.05).The incidence of complications in the observation group was 11.11%,which was significantly lower than 27.78%in the control group(P<0.05).Conclusion:Xuebijing combined with somatostatin can effectively promote the recovery of clinical signs or symptoms in patients with SAP,inhibit pancreatic enzyme release and inflammatory response,and reduce the incidence of complications and improve prognosis.