奥曲肽联合加贝酯治疗重症急性胰腺炎患者的临床疗效

Clinical efficacy of octreotide combined with gabexate in the treatment of patients with severe acute pancreatitis

目的探讨奥曲肽联合加贝酯治疗重症急性胰腺炎患者的临床疗效。方法选取2018年1月至2022年5月济南市第七人民医院收治80例重症急性胰腺炎患者作为研究对象,随机分为A组与B组,各40例。A组给予奥曲肽治疗,B组给予奥曲肽联合加贝酯治疗,比较两组预后情况、症状缓解时间、炎症因子、胃肠道屏障相关指标、血液流变学指标及不良反应发生情况。结果治疗后,两组急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分、腹压水平均低于治疗前,且B组低于A组,差异有统计学意义(P<0.05)。B组血淀粉酶恢复时间、尿淀粉酶恢复时间、肠鸣音恢复时间、腹痛缓解时间均短于A组,差异有统计学意义(P<0.05)。治疗后,两组白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)水平均低于治疗前,且B组低于A组,差异有统计学意义(P<0.05)。治疗后,两组尿乳果糖/甘露醇(L/M)、血二胺氧化酶(DAO)、D-乳果糖水平均低于治疗前,且B组低于A组,差异有统计学意义(P<0.05)。治疗后,两组全血比黏度高切(BVH)、血浆比黏度(PV)、血小板黏附率(PAdT)均低于治疗前,血栓长度(TL)均短于治疗前,且B组BVH、PV、PAdT均低于治疗前,TL短于A组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论奥曲肽联合加贝酯治疗重症急性胰腺炎患者疗效显著,可改善患者预后,降低其血清炎症因子水平,改善其胃肠道屏障功能及血液流变学指标,且未增加不良反应发生率,值得临床推广应用。

Objective To explore the clinical efficacy of octreotide combined with gabexate in the treatment of patients with severe acute atitis.Methods 80 patients with severe acute pancreatitis admitted to Jin'an Seventh People's Hospital from January 2018 to May 2022 were as the study subjects,they were randomly divided into the group A and the group B,with 40 cases in each group.The group A was treated with octreo-tide,and the group B was treated with octreotide combined with gabexate,the prognosis,symptom relief time,inflammatory factors,gastrointestinal barrier related indicators,hemorheology indicators and adverse reactions were compared between the two groups.Results After treatment,the acute physiology and chronic health evaluationⅡ(APACHEⅡ)score and abdominal pressure level of the two groups were lower than those before treat-ment,and the group B was lower than the group A,the differences were statistically significant(P<0.05).The blood amylase recovery time,urine am-ylase recovery time,bowel sound recovery time and abdominal pain relief time in group B were shorter than those in group A,and the differences were statistically significant(P<0.05).After treatment,the levels of interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and procalcitonin(PCT)of the two groups were lower than those before treatment,and the group B were lower than the group A,the differences were sta-tistically significant(P<0.05).After treatment,the levels of urinary lactulose/mannitol(L/M),diamine oxidase(DAO)and D-lactulose of the two groups were lower than those before treatment,and the group B was lower than the group A,the differences were statistically significant(P<0.05).Af-ter treatment,the blood specific viscosity(BVH),plasma specific viscosity(PV)and platelet adhesion rate(PAdT)of the two groups were lower than before treatment,and the thrombus length(TL)was shorter than before treatment,and BVH,PV and PAdT in the group B were lower than before treat-ment,and TL was shorter than the group A,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Octreotide combined with gabexate is effective in the treatment of patients with severe acute pancreatitis,it can improve the prognosis,reduce the level of serum inflammatory factors,improve the gastrointestinal barrier function and hemorheology indexes,and does not increase the incidence of adverse reactions,it is worthy of clinical promotion and application.