丙氨酰谷氨酰胺联合奥曲肽对重症急性胰腺炎患者的临床疗效

目的:探讨丙氨酰谷氨酰胺(Ala-Gln)联合奥曲肽治疗重症急性胰腺炎(SAP)的临床疗效及对患者血清白细胞介素-6(IL-6)、C反应蛋白(CRP)水平及相关生化指标的影响。方法:选取我院2013年1月~2016年12月收治的100例SAP患者,根据随机数字表法均分为两组。对照组仅予以奥曲肽治疗,观察组给予Ala-Gln联合奥曲肽治疗。记录比较两组的临床疗效、治疗前后血清IL-6、CRP、淀粉酶(AMY)、乳酸脱氢酶(LDH)、前清蛋白(PA)和白蛋白(ALB)水平的变化情况。结果:治疗10 d后,观察组总有效率为88.0%,明显高于对照组的64.0%(P0.05)。两组治疗10 d后血清IL-6、CRP、AMY、LDH水平均显著低于治疗前(P0.01),且与对照组对比,观察组血清IL-6、CRP、AMY、LDH水平的改善程度均更为显著(P0.01)。与治疗前相比,两组治疗10 d后血清PA、ALB水平均明显上升(P0.05),且观察组治疗10 d后血清PA和ALB水平的改善程度均显著优于对照组(P0.01)。结论:丙氨酰谷氨酰胺联合奥曲肽治疗更能有效消除或缓解重症急性胰腺炎患者的症状与体征,控制机体炎症反应,提高营养代谢水平,改善预后。

Clinical Effect of Alanyl Glutamine Combined with Octreotide on Severe Acute Pancreatitis

ABSTRACT Objective: To explore the clinical efficacy of alanyl glutamine (Ala-Gln) combined with octreotide in the treatment of severe acute pancreatitis (SAP) and its effects on the serum interleukin-6 (IL-6), C reactive protein (CRP) levels and related biochemical parameters. Methods: 100 cases of patients with SAP in our hospital from January 2013 to December 2016 were selected and randomly divided into two groups. The control group was treated by octreotide, while the observation group was treated by Ala-Gln combined with octreotide. The clinical effect, changes of serum IL-6, CRP, amylase (AMY), lactate dehydrogenase (LDH), prealbumin (PA) and albu- min (ALB) levels before and after therapy were compared between two groups. Results: On the 10th day after treatment, the overall ef- fective rate of observation group was 88.0% which was significantly higher than that of the control group (64.0%, P<0.05). The serum IL-6, CRP, AMY and LDH levels of both groups on the 10th day after treatment were significantly lower than those before treatment (P<0.01). Compared with the control group, the improvement of serum IL-6, CRP, AMY, LDH levels of observation group were more significant(P<0.01). Compared with those before treatment, the serum PA and ALB levels of both groups were significantly increased on the 10th day after treatment(P<0.05), and the improvement of serum PA and ALB levels of observation group on the 10th day after treat- ment were significantly better than those of the control group(P<0.01). Conclusion: Alanyl glutamine combined with octreotide could effec- tively eliminate or alleviate the symptoms and signs of patients with severe acute pancreatitis, control the inflammatory reaction, improve the level of metabolism, improve the prognosis.