连续性静脉-静脉血液滤过联合亚胺培南西司他丁钠、乌司他丁治疗重症急性胰腺炎的效果及对炎性反应的影响

Effect of continuous veno-venous hemofiltration combined with imipenem and cilastatin sodium and ulinastatin in the treatment of severe acute pancreatitis and its influence on inflammatory response

目的探讨连续性静脉-静脉血液滤过(CVVH)联合亚胺培南西司他丁钠、乌司他丁治疗重症急性胰腺炎(SAP)的效果及对炎性反应的影响。方法择取2021年4月至2022年4月收治的100例SAP患者为研究对象,将其随机分为对照组和观察组,各50例。对照组给予亚胺培南西司他丁钠、乌司他丁治疗,观察组在对照组基础上加用CVVH治疗。比较两组的治疗效果。结果观察组的治疗总有效率高于对照组,差异具有统计学意义(P<0.05)。观察组的白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及C-反应蛋白(CRP)水平均低于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的Toll样受体4(TLR4)、核因子-κB(NF-κB)水平低于对照组,差异具有统计学意义(P<0.05)。结论CVVH联合亚胺培南西司他丁钠、乌司他丁治疗SAP的效果显著,可有效抑制机体炎性反应,调节NF-κB、TLR4水平,值得推广。

Objective To explore the effect of continuous veno-venous hemofiltration(CVVH)combined with imipenem and cilastatin sodium and ulinastatin in the treatment of severe acute pancreatitis(SAP)and its influence on inflammatory response.Methods A total of 100 SAP patients admitted from April 2021 to April 2022 were selected as the study objects and randomly divided into control group and observation group,with 50 cases in each group.The control group was treated with imipenem and cilastatin sodium and ulinastatin,and the observation group was treated with CVVH on the basis of the control group.The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).The levels of interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of Toll-like receptor 4(TLR4)and nuclear factor-κB(NF-κB)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion CVVH combined with imipenem and cilastatin sodium and ulinastatin is effective in the treatment of SAP.It can effectively inhibit the inflammatory response of the body and regulate the levels of NF-κB and TLR4.It is worthy of promotion.