乌司他丁联合奥曲肽治疗高脂血症性急性胰腺炎的效果观察

Effect of ulinastatin combined with octreotide on hyperlipidemic acute pancreatitis

目的分析乌司他丁联合奥曲肽治疗高脂血症性急性胰腺炎(HLAP)患者的临床效果。方法抽取2019年5月至2021年5月河南医学高等专科学校附属医院收治的HLAP患者110例,按随机数字表法分为联合组与单一组,每组55例。单一组采用奥曲肽治疗,联合组在单一组治疗基础上加用乌司他丁。比较两组疗效、症状改善情况、不良反应发生率及治疗前后血脂水平、炎性因子、血液流变学、血淀粉酶(AMS)变化。结果联合组总有效率(96.36%,53/55)高于单一组(83.64%,46/55),P<0.05。联合组肠鸣音恢复时间、恢复进食时间、腹痛消失时间、腹胀消失时间均短于单一组(P均<0.05);治疗后,联合组血脂水平、炎性因子水平、AMS水平和血浆黏度、全血低切黏度、全血高切黏度、血小板聚集率均低于单一组(P均<0.05)。两组不良反应发生率比较差异未见统计学意义(P>0.05)。结论乌司他丁联合奥曲肽治疗HLAP可提高疗效,降低血脂水平,缓解炎症状态,调节血液微循环,加快症状改善,且具有安全性。

Objective To analyze the clinical effects of ulinastatin combined with octreotide in the treatment of patients with hyperlipidemic acute pancreatitis(HLAP).Methods A total of 110 HLAP patients treated in Affiliated Hospital of Henan Medical College from May 2019 to May 2021 were selected and divided into combined group and single group according to the random number table method,with 55 cases in each group.Octreotide was used in the single group,and ulinastatin was used in the combination group based on the treatment of the single group.The efficacy,improvement of symptoms,incidence of adverse reactions,preoperative and postoperative blood lipid levels,inflammatory factors,hemorheology,and amylase(AMS)were compared between the two groups.Results The total effective rate of the combined group(96.36%,53/55)was higher than that of the single group(83.64%,46/55),P<0.05.The recovery time of bowel sounds,food intake,abdominal pain and abdominal distension in the combined group were shorter than those in the single group(all P<0.05).The blood lipid level,inflammatory factor level,AMS level,plasma viscosity,whole blood low shear viscosity,whole blood high shear viscosity and platelet aggregation rate in the combined group were lower than those in the single group after treatment(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions Ulinastatin combined with octreotide in the treatment of HLAP can improve the curative effect,reduce the blood lipid level,alleviate the inflammatory state,regulate the blood microcirculation,and accelerate the improvement of symptoms,with good safety.