乌司他丁治疗不同类型急性胰腺炎的临床疗效

目的:探讨乌司他丁用于治疗不同类型急性胰腺炎的临床疗效和安全性。方法:收集2013年1月至2014年1月我院收治的急性胰腺炎患者84例,随机分为观察组与对照组,每组各42例,两组患者均给予常规治疗,对照组加用奥曲肽治疗,观察组在对照组的基础上加用乌司他丁治疗,观察和比较两组患者的临床疗效、治疗前后血清IL-6和TNF-α水平的变化及不良反应的发生情况。结果:观察组的总有效率为96.72%,显著高于对照组的85.71%;其中,两组急性水肿型胰腺炎的疗效相当(P0.05),但观察组出血坏死型胰腺炎的有效率显著高于对照组(P0.05)。治疗后,两组血清IL-6与TNF-α水平均较治疗前显著降低,并且观察组显著低于对照组(P0.05),水肿型胰腺炎患者血清IL-6及TNF-α水平显著低于出血坏死型胰腺炎患者,差异均具有统计学意义(P0.05)。两组均未发生肝肾功能损害,未见药物相关性不良反应。结论:乌司他丁用于辅助治疗急性胰腺炎能够明显下调炎症因子水平,临床疗效显著,对急性水肿型胰腺炎的疗效尤为显著,安全性好,值得推广应用。

Clinical Efficacy of Ulinastatin in the Treatment of Different Typesof Acute Pancreatitis

Objective:To investigate the clinical efficacy and safety of ulinastatin in treatment of different types of acutepancreatitis.Methods:84 cases of patients with acute pancreatitis admitted in our hospital from January 2013 to January 2014 wereselected and randomly divided into the observation group and control group. Both groups received conventional treatment, the controlgroup received octreotide treatment, observation group received ulinastatin on the basis of the control group, the clinical efficacy, serumIL-6 and TNF-alpha levels before and after treatment, the occurrence of adverse reactions of two groups were compared.Results:The totaleffective rate of observation group was 96.72%, which was significantly higher than that of the control group (85.71%); no significantdifference was found in the efficacy of acute edematous pancreatitis (AEP) betwen the two groups (P<0.05), but the efficiency of acutehemorrhagic necrotizing pancreatitis (AHNP) in the observation group was significantly higher than that of the control group(P<0.05).After treatment, the serum IL-6 and TNF-alpha levels of both groups were significantly lower than those before treatment (P<0.05), and theserumIL-6 and TNF-alpha levels of observation group were significantly lower than those of the control group (P<0.05), the serum IL-6 andTNF-alpha levels of patients with AEP were significantly lower than those with AHNP (P<0.05). There was no significant difference ordrug-related adverse reactions in the liver and kidney dysfunction between two groups.Conclusion:Ulinastatin could significantly lowerthe levels of inflammatory factors in the treatment of AEP and AHNP and had significant clinical effect on the AEP, it should be widelyapplied in clinic.