高脂血症性急性胰腺炎患者进行早期降脂治疗的临床效果

目的了解高脂血症性急性胰腺炎(hyperlipidemic acute pancreatitis,HLP)患者进行早期降脂治疗的临床效果,为各种降脂治疗方法应用于HLP患者提供理论经验.方法随机抽取2014-01/2016-07之间,对290例高脂血症性胰腺炎患者进行研究,根据其入院单双日均分为对照组(常规治疗)和实验组(常规疗法基础上采用二次膜分离血浆置换),均进行为期1 mo的治疗,比较两组患者量表评分[Ramson、急性生理和慢性健康状态评分系统评分(acute physiology and chronic health evaluationⅡscore,APACHEⅡ)、MCTSI量表];血流流变学指标(高切全血黏度、低切全血黏度、血浆比黏度、纤维蛋白原、血细胞比容、血小板聚集率、红细胞沉降率);特异性指标[血清淀粉酶、尿淀粉酶、血钙、白介素(interleukin,IL)-6、肿瘤坏死因子-α(tumor necrosis factorα,TNF-α)]的差异.结果治疗后,HLP患者血清甘油三脂含量与其他指标(Ramson评分、APACHEⅡ评分、MCTSI评分、高切全血黏度、低切全血黏度、血浆比黏度、纤维蛋白原、血细胞比容、血小板聚集率、红细胞沉降率、血清淀粉酶、尿淀粉酶、血钙、IL-6、TNF-α)进行相关性分析,均有统计学意义(P<0.05).两组患者治疗前、治疗后分别进行比较,Ranson评分、APACHEⅡ评分、Balthazar CT评分、高切全血黏度、低切全血黏度、血浆比黏度、纤维蛋白原、血细胞比容、血小板聚集率、红细胞沉降率、血清淀粉酶、尿淀粉酶、血钙、IL-6、TNF-α的差异均有统计学意义(P<0.05).治疗后比较,实验组和对照组之间Ranson评分、APACHEⅡ评分、Balthazar CT评分、高切全血黏度、低切全血黏度、血细胞比容、血清淀粉酶、尿淀粉酶、IL-6、TNF-α的差异均有统计学意义(P<0.05),且实验组患者各项评分均好于对照组.两组患者治疗后,血清三酰甘油均有明显下降,实验组0.31 mmol/L±0.14 mmol/L患者治疗后血清三酰甘油高于对照(0.62 mmol/L±0.11mmol/L,差异有统计学意义(P<0.05).结论对HLP患者进行早期降脂治疗,相比常规治疗方法的疗效更好,值得在临床上推广应用.

Effects of respiratory rehabilitation training combined with Corbrin Capsule on the inflammatory response and pulmonary fibrosis in patients with silicosis complicated by COPD

Objective: To explore the effects of respiratory rehabilitation training combined with Corbrin Capsule on the inflammatory response and pulmonary fibrosis in patients with silicosis complicated by COPD. Methods: A total of 80 patients with silicosis complicated by COPD who were treated in our hospital between January 2013 and December 2016 were selected as the research subjects and randomly divided into control group (n=40) and observation group (n=40). Control group were treated with Corbrin Capsule on the basis of routine treatment, and observation group were treated with respiratory rehabilitation training combined with Corbrin Capsule on the basis of routine treatment. The differences in serum levels of inflammatory factors and pulmonary fibrosis indexes were compared between the two groups before intervention, after 6 months of intervention and after 1 year of intervention. Results: Before intervention, there was no statistically significant difference in serum levels of inflammatory factors and pulmonary fibrosis indexes between the two groups. After 6 months of intervention and after 1 year of intervention, serum inflammatory factors IL-6, IL-8, IL-12, IL-17, IL-18 and MCP-1 levels of observation group were lower than those of control group;serum pulmonary fibrosis indexes PCⅢ, LN, HA, ICAM-1 and HO-1 contents were lower than those of control group. Conclusion: Respiratory rehabilitation training combined with Corbrin Capsule therapy can effectively reduce the systemic inflammatory response and inhibit the pulmonary fibrosis process in patients with silicosis complicated by COPD.