奥曲肽不同给药方式对急性胰腺炎患者肠黏膜通透性及血液流变学指标的影响

Effects of different administration methods of octreotide on intestinal mucosal permeability and hemorheology in patients with acute pancreatitis

目的 探讨奥曲肽不同给药方式对急性胰腺炎患者肠黏膜通透性及血液流变学指标的影响。方法 选取2021年2月至2022年10月河南省直第三人民医院收治的急性胰腺炎患者,随机分为对照组和观察组,均给予奥曲肽治疗,对照组采取常规静脉滴注方式,观察组采取静脉微量泵入方式。比较两组患者治疗前后肠黏膜功能指标、血液流变学指标和炎症因子变化情况。结果 共纳入患者106例,对照组与观察组各53例。治疗后观察组二胺氧化酶(DAO)、D-乳酸、乳果糖/甘露醇(L/M)比值[(4.56±0.78)U/mL、(5.04±0.46)mg/L、0.24±0.04]比对照组[(7.04±0.86)U/mL、(6.23±0.57)mg/L、0.51±0.06]降低;血液流变学指标如全血比黏度(高切)、血小板黏附率、血浆比黏度、红细胞压积[(4.96±0.32)map/s、36.73%±3.54%、1.75%±0.14%、40.35%±3.47%]比对照组[(5.67±0.45)map/s、52.96%±3.62%、1.97%±0.12%、44.24%±3.52%]下降;C反应蛋白(CRP)、IL-17、IL-6水平[(52.62±3.72)mg/L、(6.56±0.57)ng/L、(5.06±0.45)ng/L]比对照组[(68.34±3.94)mg/L、(8.25±0.78)ng/L、(7.74±0.63)ng/L]降低,差异均有统计学意义(P<0.05)。结论 静脉微量泵入奥曲肽治疗急性胰腺炎,可以有效改善肠黏膜功能,降低炎症因子水平。

Objective To explore the effects of different administration methods of octreotide on intestinal mucosal permeability and hemorheology in patients with acute pancreatitis.Methods Patients with acute pancreatitis in the Henan Province Third People's Hospital from February 2021 to October 2022 were selected as the study objects and were randomly divided into the control group and the observation group,both receiving octreotide treatment.The control group received a routine intravenous drip,while the observation group received an intravenous micropump.The efficacy and the adverse reactions between the two groups and compared the changes in intestinal mucosal functional indicators,hemorheological indicators,and inflammatory factors,between the two groups before and after treatment were observed.Results A total of 106 patients were included,with 53 in each group.After treatment,the levels of diamine oxidase(DAO),D-lactate,lactulose/mannitol(L/M) ratio [(4.56±0.78)U/m L,(5.04±0.46)mg/L,0.24±0.04],hemorheology indexes such as whole blood viscosity(high shear) value,platelet adhesion rate,the ratio of viscosity and hematocrit [(4.96±0.32)map/s,36.73%±3.54%,1.75%±0.14%,40.35%±3.47%],C-reactive protein(CRP),IL-17,and IL-6[(52.62±3.72)mg/L,(6.56±0.57)ng/L,(5.06±0.45)ng/L] in the observation group were lower than those in the control group[(7.04±0.86) U/mL,(6.23±0.57)mg/L,0.51±0.06],[(5.67±0.45)map/s,52.96%±3.62%,1.97%±0.12%,44.24%±3.52%],[(68.34±3.94)mg/L,(8.25±0.78)ng/L,(7.74±0.63)ng/L],and the differences were statistically significant(P<0.05).Conclusion Micro intravenous infusion of octreotide in the treatment of acute pancreatitis can effectively improve intestinal mucosal function,and reduce inflammatory factor expression levels.