乌司他丁联合奥曲肽对急性重症胰腺炎患者的临床研究

Clinical trial of ulinastatin combined with octreotide in the treatment of patients with severe acute pancreatitis

目的观察乌司他丁联合奥曲肽素对急性重症胰腺炎(SAP)患者血清炎性因子和降钙素原(PCT)的影响。方法将84例SAP患者随机分为对照组和试验组,每组各42例。对照组给予醋酸奥曲肽注射液,每次0. 1 mg,每天3次,皮下注射;试验组在对照组的基础上给予乌司他丁注射液,10万单位加入5%的葡萄糖500 mL,每天2次,静脉滴注,2组均连续治疗14 d。观察2组患者的炎症因子、PCT、淀粉酶和内毒素水平变化及药物不良反应发生情况。结果治疗后,对照组与试验组血清肿瘤坏死因子-α(TNF-α)分别为(256. 37±89. 88),(141. 09±54. 01) pg·mL-1;白细胞介素-6(IL-6)分别为(83. 87±23. 09),(30. 17±10. 18) pg·mL-1;白细胞介素-8 (IL-8)分别(95. 79±21. 18),(51. 89±16. 27) pg·mL-1;血清淀粉酶分别为(256. 87±87. 66),(107. 31±40. 86) U·L-1;尿液淀粉酶分别为(1525. 86±230. 65),(568. 72±75. 87) U·L-1;PCT分别为(4. 08±2. 16),(2. 58±1. 62) mg·L-1;内毒素分别为(0. 16±0. 03),(0. 05±0. 01) EU·mL-1,差异均有统计学意义(均P <0. 05)。对照组和试验组药物不良反应发生率分别为14. 29%,9. 52%,差异无统计学意义(P> 0. 05)。结论乌司他丁联合奥曲肽治疗SAP,能有效抑制机体炎症反应,保护肠黏膜,降低PCT、淀粉酶及内毒素水平。

Objective To observe the effect of ulinastatin combined with octreotide on serum inflammatory factors and procalcitonin(PCT)in patients with severe acute pancreatitis(SAP).Methods Eight-four patients with SAP treated were randomly divided into control group and treatment group,with 42 patients in each group.Control group was treated with octreotide injection 0.1 mg·time-1,3 times·d-1,subcutaneous injection);treatment group was treated with ulinastatin injection 1.0×105 U add into 5%glucose solution 500 mL,2 times·d-1,intravenous drip,on the basis of control group.All patients were treated for 14 d.The levels of inflammatory factors,PCT,amylase and endotoxin were observed between the two groups;the related adverse drug reactions in two groups during treatment were compared.Results After treatment,the serum tumor necrosis factor-α(TNF-α)in control group and treatment group were(256.37±89.88),(141.09±54.01)pg·mL-1,interleukin-6(IL-6)were(83.87±23.09),(30.17±10.18)pg·mL-1,interleukin-8(IL-8)were(95.79±21.18),(51.89±16.27)pg·mL-1,serum amylase were(256.87±87.66),(107.31±40.86)U·L-1,urine amylase were(1525.86±230.65),(568.72±75.87)U·L-1,PCT were(4.08±2.16),(2.58±1.62)mg·L-1,endotoxin were(0.16±0.03),(0.05±0.01)EU·mL-1,all with statistical difference(all P<0.05).The incidence of adverse drug reactions in control group and treatment group were 14.29%,9.52%,with no significant difference(P>0.05).Conclusion Ulinastatin combined with octreotide in the treatment of SAP can effectively inhibit the inflammatory response,protect the intestinal mucosa,and reduce the levels of PCT,amylase and endotoxin.