头孢曲松治疗急性胰腺炎的临床效果及对患者血清炎症因子的影响

目的:探讨头孢曲松联合质子泵抑制剂对急性胰腺炎患者血清IL-6,C反应蛋白及降钙素原的影响及及临床疗效。方法:收集我院就诊的118例急性胰腺炎患者,随机分为实验组和对照组,每组59例。对照组患者给予奥美拉唑治疗,实验组患者在对照组基础上给予头孢曲松钠治疗。观察并比较两组患者治疗前后血清C反应蛋白(CRP)、白介素-6(IL-6)、降钙素原(PCT)水平变化及临床疗效。结果:与治疗前相比,治疗后两组患者血清CRP,IL-6及PCT水平均下降,差异具有统计学意义(P0.05);与对照组相比,实验组患者CRP,IL-6及PCT水平较低,差异具有统计学意义(P0.05);与对照组相比,实验组患者临床治疗有效率较高,差异具有统计学意义(P0.05)。结论:头孢曲松联合质子泵抑制剂能够降低急性胰腺炎患者血清CRP、IL-6、PCT水平,临床疗效较好。     

Pivotal participation of nitrogen dioxide in L-arginine induced acute necrotizing pancreatitis: protective role of superoxide scavenger 4-OH-TEMPO

For the first time, a direct sensitive method of *NO(2) detection and measurement in biological material has been established. It is based on the interaction of this radical with the coordination compound of Cr(III) with aminodeoxysugar as biosensor. Our new method makes it possible to precisely assess *NO(2) level in experimental acute necrotizing pancreatitis induced by L-arginine, where oxidative and nitrosative stresses are supposed to play a key role in the pathomechanism of the disease. As much as 20 nmol of *NO(2)/mg protein was detected which correlated with severe deterioration of pancreatic acinar cell ultrastructure. Protective effect of superoxide radical scavenger 4-OH-TEMPO expressed as *NO(2) level decrease confirmed by preserved acinar cell ultrastructure and decreased pancreatic amylase release to blood serum is demonstrated. This study reveals a possible pathomechanism of L-arginine induced acute pancreatitis.     

异甘草酸镁对急性重症胰腺炎患者血清CAM-1、SIL-2R、IL-2水平及肝肾功能的影响

目的:探讨异甘草酸镁对急性重症胰腺炎患者血清胞间粘附分子-1(CAM-1)、可溶性白细胞介素-2受体(SIL-2R)、白细胞介素-2(IL-2)水平及肝肾功能的影响。方法:选择2014年3月～2016年9月于我院接受治疗的86例急性重症胰腺炎患者,按随机数字表法分为对照组与实验组,每组43例。对照组选用常规治疗,实验组在常规治疗基础上加以异甘草酸镁治疗,两组均持续治疗14天。比较两组的临床疗效,治疗前后血清CAM-1、SIL-2R、IL-2、谷草转氨酶、谷丙转氨酶、尿素氮、血肌酐水平的变化及不良反应的发生情况。结果:治疗后,实验组总有效率为90.69%,显著高于对照组(P0.05);两组血清CAM-1、SIL-2R、IL-2、谷草转氨酶、谷丙转氨酶、尿素氮、血肌酐水平均较治疗前显著降低,且实验组以上指标均明显低于对照组(P0.05)。两组不良反应发生情况比较差异无统计学意义(P0.05)。结论:与常规治疗相比,异甘草酸镁可显著提高急性重症胰腺炎的临床效果,降低血清CAM-1、SIL-2R、IL-2水平,保护肝肾功能。     

丹参川芎嗪注射液联合乌司他丁对重症急性胰腺炎患者血清炎症因子、细胞免疫功能及生活质量的影响

摘要 目的：探讨丹参川芎嗪注射液联合乌司他丁对重症急性胰腺炎（SAP）患者血清炎症因子、细胞免疫功能及生活质量的影响。方法：本次研究为前瞻性研究,选取2017年8月~2020年6月期间我院收治的SAP患者120例,根据信封抽签法将患者分为对照组（乌司他丁治疗）和实验组（对照组的基础上联合丹参川芎嗪注射液治疗）,各为60例。对比两组疗效、临床症状改善时间及住院时间、血清炎症因子、细胞免疫功能及生活质量,记录两组不良反应情况、外科手术率及病死率。结果：实验组治疗2周后的总有效率高于对照组（P<0.05）。两组治疗2周后血清C反应蛋白（CRP）、白介素-6（IL-6）及肿瘤坏死因子-α（TNF-α）水平均较治疗前下降,且实验组低于对照组（P<0.05）。两组治疗2周后CD8⁺较治疗前下降,且实验组低于对照组（P<0.05）,CD3⁺、CD4⁺、CD4⁺/CD8⁺较治疗前升高,且实验组高于对照组（P<0.05）。两组治疗2周后生理职能、社会功能、情感职能、躯体疼痛、生理机能、活力、精神健康、健康状况评分较治疗前升高,且实验组高于对照组（P<0.05）。实验组血淀粉酶恢复正常时间、肠鸣音恢复时间、住院时间、排气恢复时间、腹胀腹痛消除时间较对照组更短（P<0.05）。两组不良反应发生率、外科手术率、病死率对比组间无差异（P>0.05）。结论：丹参川芎嗪注射液联合乌司他丁治疗SAP患者,可促进症状改善,降低炎症因子水平,改善患者免疫功能及生活质量,安全有效。     

肠内营养不同递增输注速度对重症急性胰腺炎患者喂养耐受性、生存质量和胃肠功能恢复的影响

摘要 目的：观察肠内营养不同递增输注速度对重症急性胰腺炎（SAP）患者喂养耐受性、生存质量和胃肠功能恢复的影响。方法：选取2019年3月~2021年2月期间我院收治的SAP患者120例，按照随机数字表法分为低速组、中速组和高速组，各为40例，输注速度递增幅度由低到高给予肠内营养。对比三组患者的腹内压、喂养耐受性、生存质量和胃肠功能恢复情况。结果：干预8 h后、干预16 h后、干预20 h后低速组腹内压低于高速组、中速组，而中速组低于高速组（P<0.05）。低速组排气排便恢复时间、肠鸣音恢复时间、经口进食时间、腹胀缓解时间短于中速组、高速组，中速组则短于高速组（P<0.05）。低速组干预7 d后世界卫生组织生存质量简明量表（WHO-QOL-BREF）各维度评分高于中速组、高速组，中速组则高于高速组（P<0.05）。低速组喂养不耐受发生率低于中速组、高速组，中速组则低于高速组（P<0.05）。结论：肠内营养低速递增输注有利于防止腹内压升高，提高SAP患者喂养耐受性，促进胃肠功能恢复，进而提高患者生存质量。     

Kynurenine monooxygenase regulates inflammation during critical illness and recovery in experimental acute pancreatitis

1. Download : Download high-res image (117KB)
2. Download : Download full-size image

     

Comparison of New Glucose-Lowering Drugs on the Risk of Pancreatitis in Type 2 Diabetes: A Network Meta-Analysis

ObjectiveTo explore whether new glucose-lowering drugs increase the risk of pancreatitis in individuals with type 2 diabetes. This present network meta-analysis aimed to investigate the risk of pancreatitis associated with the use of glucagon-like peptide-1 (GLP-1) agonists and dipeptidyl peptidase-4 (DPP-4) inhibitors in the treatment of type 2 diabetes mellitus.MethodsPubMed, Web of Science, Embase, and the Cochrane Library were searched. The literature was published from the date of their inception to July 21, 2021, including placebo-controlled or head-to-head trials of 2 new glucose-lowering drugs. The relative ratio (RR) and 95% confidence interval (CI) were used to assess the risk of GLP-1 agonists and DPP-4 inhibitors for pancreatitis or pancreatic cancer among patients with type 2 diabetes.ResultsSeventeen studies were identified, covered 102 257 participants. The pooled results showed a neutral relationship between GLP-1 agonists and pancreatitis (overall RR, 0.96; 95% CI, 0.31-3.00) or pancreatic cancer (overall RR, 1.10; 95% CI, 0.31-4.10) compared with placebo. Meanwhile, DPP-4 inhibitors were not associated with the increased risk of pancreatitis (overall RR, 1.60; 95% CI, 0.25-11.00) or pancreatic cancer (overall RR, 0.79; 95% CI, 0.26-2.40). Among them, lixisenatide and saxagliptin may be the safest drugs compared with other drugs according to the ranking of probability. Sensitivity and subgroup analysis confirmed the stability of the core results.ConclusionThe most obvious finding of this study is that GLP-1 agonists and DPP-4 inhibitors are safe with respect to the risk of pancreatitis and pancreatic cancer compared with placebo. This conclusion may provide useful evidence for correlated clinical researches.     

Quantitative determination of metabolites in human urine by <Superscript>1</Superscript>H NMR spectroscopy

Conditions for registration of urinary ¹H NMR spectra have been optimized in order to achieve maximal accuracy of quantitative analysis. Urinary samples from patients with acute pancreatitis have been investigated and spectral data of identified urinary metabolites and results of their quantitative determination are given. Employment of ¹H NMR spectra is perspective for the development of new laboratory diagnostic methods.