连续性血液净化治疗重症急性胰腺炎的临床观察

Clinical Observation of Continuous Blood Purification in the Treatment of Severe Acute Pancreatitis

目的观察连续性血液净化(CBP)对重症急性胰腺炎(SAP)患者肠道屏障功能的影响。方法选取我院收治的60例SAP患者为研究对象,随机分为CBP治疗组和对照组,每组各30例,对照组予以常规治疗,CBP治疗组在对照组的基础上给予CBP治疗,两组均治疗1周。比较两组的临床疗效,采用分光光度法检测二胺氧化酶(DAO)、D-乳酸和内毒素水平,比较两组的肠道屏障功能,采用酶联免疫法检测血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、白介素-8(IL-8)D等炎性因子水平。结果 CBP治疗组治疗总有效率为90.00%,对照组的治疗总有效率为83.33%,差异具有统计学意义(P<0.05);治疗后,两组的DAO、D-乳酸、内毒素水平与炎性因子水平均有下降,且CBP治疗组的DAO、D-乳酸、内毒素水平与TNF-α、IL-6、IL-8水平低于对照组,差异具有统计学意义(P<0.05)。结论 CBP可通过降低SAP患者体内炎性因子水平,改善肠道屏障功能,显著提高治疗SAP的疗效,具有一定的临床意义。

Objective To observe the effects of continuous blood purification(CBP) on intestinal barrier function in patients with severe acute pancreatitis(SAP). Methods 60 patients with SAP admitted to our hospital were selected for the study and were randomly divided into CBP treatment group and control group, with 30 cases in each group. Control group was given routine treatment, and CBP treatment group was given CBP treatment on the basis of control group, and the two groups were treated for 1 w. The clinical efficacy of the two groups was compared. The levels of diamine oxidase(DAO), D-lactic acid and endotoxin were measured by spectrophotometry. The intestinal barrier function of the two groups was compared. The levels of inflammatory factors of serum tumor necrosis factor-α(TNF-α), interleukin-6(IL-6) and interleukin-8(IL-8) were detected by enzyme-linked immunosorbent assay. Results The total effective rate of treatment was 90.00% in CBP treatment group and 83.33% in control group(P<0.05). After treatment, the levels of DAO, D-lactic acid and endotoxin and the levels of inflammatory factors in the two groups were decreased,and the levels of DAO, D-lactic acid, endotoxin and TNF-α, IL-6 and IL-8 in CBP treatment group were lower than those in control group(P<0.05). Conclusion CBP can improve the intestinal barrier function by reducing the levels of inflammatory factors in SAP patients, and it can significantly improve the efficacy of SAP, and it has certain clinical significance.