丙氨酰谷氨酰胺辅助乌司他丁治疗重症急性胰腺炎肺损伤的效果及对肺功能、炎症反应、免疫功能的影响

Effect of Alanyl Glutamine-assisted Ulinastatin in the treatment of severe acute pancreatitis lung injury and the influence on lung function,inflammation,and immune function

目的探究与分析丙氨酰谷氨酰胺辅助乌司他丁治疗重症急性胰腺炎肺损伤的效果及对肺功能、炎症反应、免疫功能的影响。方法选取山东中医药大学第二附属医院2017年8月至2020年8月收治的重症急性胰腺炎肺损伤患者96例,采取随机数字表法将其分为对照组和观察组,每组各48例。对照组给予乌司他丁治疗,观察组在对照组基础上加用丙氨酰谷氨酰胺辅助治疗。连续治疗1周后,比较两组治疗前后肺部CT形态学分级、病情严重程度、血气指标,以及血清γ干扰素(IFN-γ)、白细胞介素-4(IL-4)、IFN-γ/IL-4、IL-6、肿瘤坏死因子-α(TNF-α)水平。结果治疗后,两组肺部CT形态学分级优于治疗前,急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分、Balthazar CT评分、Murray肺损伤评分、血清IFN-γ、IL-6、IFN-γ/IL-4、TNF-α均低于治疗前,动脉血氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))、氧合指数、IL-4高于治疗前,且观察组肺部CT形态学分级优于对照组,APACHEⅡ评分、Balthazar CT评分、Murray肺损伤评分、IFN-γ、IL-6、IFN-γ/IL-4、TNF-α均低于对照组,PaO_(2)、SaO_(2)、氧合指数、IL-4高于对照组,差异均有统计学意义(P<0.05)。结论丙氨酰谷氨酰胺辅助乌司他丁治疗重症急性胰腺炎肺损伤能够促进改善血气分析指标,减少肺损伤,改善机体炎症反应及免疫功能,降低病情严重程度,改善预后。

Objective To explore and analyze the effect of Alanyl Glutamine-assisted Ulinastatin in the treatment of severe acute pancreatitis lung injury and the influence on lung function,inflammation,and immune function.Methods A total of 96 patients with severe acute pancreatitis lung injury treated in the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine were selected from August 2017 to August 2020,they were divided into control group and observation group by random number table method,48 cases in each group.Ulinastatin was given to the control group,and Alanyl Glutamine was added to the observation group on the basis of the control group.After one week of continuous treatment,lung CT morphological grade,disease severity,blood gas indexes,and serum levels of interferon-γ(IFN-γ),interleukin-4(IL-4),IFN-γ/IL-4,IL-6,and tumor necrosis factor-α(TNF-α)were compared between the two groups before and after treatment.Results After treatment,lung CT morphological grades of two groups were better than those before treatment,acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score,Balthazar CT score,Murray lung injury score,serum IFN-γ,IL-6,IFN-γ/IL-4,and TNF-α of two groups were all lower than those before treatment,arterial partial pressure of oxygen(PaO_(2)),arterial oxygen saturation(SaO_(2)),oxygenation index,and IL-4 of two groups were all higher than those before treatment,while the lung CT morphological grades of observation group were better than those of control group,APACHEⅡ score,Balthazar CT score,Murray lung injury score,serum IFN-γ,IL-6,IFN-γ/IL-4,and TNF-α of observation group were all lower than those of the control group,PaO_(2),SaO_(2),oxygenation index,and IL-4 in observation group were all higher than those in control group,the differences were statistically significant(P<0.05).Conclusion Alanyl Glutamine-assisted Ulinastatin treatment of severe acute pancreatitis lung injury can promote the improvement of blood gas analysis indicators,reduce lung injury,improve the body’s inflammatory response and immune function,reduce the severity of the disease,promote the improvement of prognosis.