异甘草酸镁联合连续性血液净化对重症急性胰腺炎合并脓毒症患者脏器功能及炎性介质水平的影响

Impacts of magnesium isoglycyrrhetinic acid combined with continuous blood purification on organ function and inflammatory mediator levels in patients with severe acute pancreatitis complicated with sepsis

目的探讨异甘草酸镁联合连续性血液净化对重症急性胰腺炎(SAP)合并脓毒症患者脏器功能及炎性介质水平的影响。方法回顾性选择2020年3月至2023年2月在苏北人民医院治疗的SAP合并脓毒症患者为研究对象,按治疗方法的不同分为观察组和对照组,每组62例。对照组使用连续性血液净化的方式进行治疗,观察组在对照组治疗的基础上加用异甘草酸镁治疗,比较两组患者治疗前后的器官功能、炎性介质水平、临床疗效和临床用药安全性。结果两组治疗后急性生理学和慢性健康状况评估Ⅱ评分和序贯器官衰竭评估评分均降低,且观察组低于对照组[(26.43±3.78)分比(35.99±3.87)分、(9.18±1.52)分比(14.51±1.88)分],差异有统计学意义(P<0.05)。两组治疗后白细胞介素(IL)-8、肿瘤坏死因子-α(TNF-α)和IL-6水平均降低,并且观察组低于对照组[(114.81±23.74)ng/L比(268.32±29.14)ng/L、(214.41±25.09)ng/L比(311.33±28.11)ng/L、(32.58±4.76)ng/L比(46.35±5.76)ng/L],差异均有统计学意义(P<0.05)。观察组治疗后临床总有效率高于对照组[96.77%(60/62)比80.65%(50/62)],差异有统计学意义(χ^(2)=6.52,P<0.05)。两组治疗后不良反应发生率比较差异无统计学意义(χ^(2)=0.08,P>0.05)。结论异甘草酸镁联合连续性血液净化能改善SAP合并脓毒症患者的脏器功能,降低炎性介质水平。

Objective To investigate the impacts of magnesium isoglycyrrhetinic acid combined with continuous blood purification on organ function and inflammatory mediator levels in patients with severe acute pancreatitis(SAP)complicated with sepsis.Methods A total of 124 patients with SAP complicated with sepsis who came to Subei People′s Hospital from March 2020 to February 2023 were grouped into an observation group(62 cases)and a control group(62 cases)according to the treatment method,the control group was treated with continuous blood purification,and the observation group was treated with magnesium isoglycyrrhetate on basis of the control group,the organ function,inflammatory mediator levels,clinical efficacy,and clinical medication safety of two groups were compared.Results After treatment,the scores of acute physiology and chronic health status assessment(APACHE)Ⅱand sequential organ failure assessment(SOFA)in both groups were decreased compared to before treatment,and the scores of APACHEⅡand SOFA in the the observation group were lower than those in the control group:(26.43±3.78)scores vs.(35.99±3.87)scores,(9.18±1.52)scores vs.(14.51±1.88)scores,there were statistical differences(P<0.05).After treatment,the levels of interleukin(IL)-8,tumor necrosis factor-α(TNF-α)and IL-6 in both groups were decreased,and the levels of IL-8,TNF-αand IL-6 in the the observation group were lower than those in the control group:(114.81±23.74)ng/L vs.(268.32±29.14)ng/L,(214.41±25.09)ng/L vs.(311.33±28.11)ng/L,(32.58±4.76)ng/L vs.(46.35±5.76)ng/L,there were statistical differences(P<0.05).The total clinical effective rate after treatment in the the observation group was higher than that in the control group:96.77%(60/62)vs.80.65%(50/62),there was statistical difference(χ^(2)=6.52,P<0.05).The incidence of adverse reactions in the two groups had no statistical difference(χ^(2)=0.08,P>0.05).Conclusions Magnesium isoglycyrrhetinic acid combined with continuous blood purification can improve organ function and reduce inflammatory mediator levels in SAP patients with sepsis.