大剂量奥曲肽联合乌司他丁治疗重症胰腺炎的可行性研究

Feasibility study of high-dose octreotide combined with ulinastatin in the treatment of severe pancreatitis

目的研究大剂量奥曲肽联合乌司他丁治疗重症胰腺炎患者的可行性。方法选取华北医疗健康集团邢台总医院2020年1月至2022年1月收治的98例重症胰腺炎患者作为研究对象,按照随机数字表法分为观察组(采用大剂量奥曲肽联合乌司他丁治疗)49例和对照组(采用乌司他丁治疗)49例。观察两组患者治疗后的临床疗效、炎症介质水平、血液微循环状态、免疫功能以及不良反应发生情况。结果治疗后,观察组总有效率为95.92%,高于对照组的83.67%,差异有统计学意义(P<0.05)。治疗后,观察组IL-6、hs-CRP、TNF-α均低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组血浆黏度、纤维蛋白原水平、血小板聚集率、全血黏度低切、全血黏度高切均低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组CD4+与CD4+/CD8+高于对照组,CD8+低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组不良反应发生情况与对照组比较,差异无统计学意义(P>0.05)。结论大剂量奥曲肽联合乌司他丁能够提高重症胰腺炎患者的临床疗效,降低体内炎症介质水平,改善血液微循环状态,提高免疫功能。

Objective To explore the feasibility of high-dose octreotide combined with ulinastatin in the treatment of patients with severe pancreatitis based on inflammatory mediators and microcirculation improvement.Methods A total of 98 patients with severe pancreatitis admitted to Xingtai General Hospital of North China Medical and Health Group from January 2020 to January 2022 were selected as the study subjects,and 49 patients were divided into the observation group(treated with high-dose octreotide combined with ulinastatin)and 49 cases in the control group(treated with ulinastatin)according to the random number table method.The clinical efficacy,inflammatory mediator level,blood microcirculation status,immune function and adverse reactions of the two groups were observed.Results After treatment,the total effective rate of the observation group was 95.92%,which was higher than that of the control group of 83.67%,and the difference was statistically significant(P<0.05).After treatment,the values of IL-6,hs-CRP and TNF-α in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,plasma viscosity,fibrinogen level,platelet aggregation rate,low whole blood viscosity and high whole blood viscosity in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,CD4 + and CD4 +/CD8 + in the observation group were higher than those in the control group,and CD8+ were lower than those in the control group,with a statistically significant difference(P<0.05).After treatment,the occurrence of adverse reactions in the observation group was not statistically significant compared with the control group(P<0.05).Conclusion High-dose octreotide combined with ulinastatin can improve the clinical efficacy of patients with severe pancreatitis,reduce the level of inflammatory mediators in vivo,improve blood microcirculation status,and improve immune function.