依泽替米贝辅助腹腔镜微创术联合治疗胆囊结石患者对炎性因子及血清CCK-A表达的影响

目的:探讨依泽替米贝辅助腹腔镜微创术联合治疗胆囊结石患者对炎性因子及胆囊收缩素A(Cholecystokinin-A,CCK-A)表达的影响。方法:以2016年2月-2018年2月我院收治的100例胆囊结石患者作为研究对象,按随机数字表法分为对照组(腹腔镜微创术)和观察组(腹腔镜微创术+依泽替米贝),每组各50例。观察并比较治疗前后两组患者临床疗效、胆囊结石数量和直径的变化、炎性因TNF-α、IL-1水平以及血清CCK-A水平的变化。结果:术后观察组感染2例,胰腺炎1例,观察组发生感染3例,两组患者并发症发生情况差异无统计学意义(P<0.05),观察组患者的治疗有效率明显高于对照组(94.0%vs 58.0%)(P<0.05);治疗前两组患者胆囊结石平均数量、直径差异无统计学意义(P>0.05),治疗后观察组和对照组患者胆囊结石数量(5.16±2.35 vs9.18±2.82)、直径(0.78±0.29 cm vs 1.26±0.36 cm)明显降低,观察组低于对照组(P<0.05);治疗前两组患者血清TNF和IL-1水平无明显差异(P>0.05),治疗后观察组和对照组患者血清TNF-α[15.28±4.28(ng/mg)vs 22.19±5.02(ng/mg)]、IL-1[63.38±8.27(μg/mg)vs 89.59±7.39(μg/mg)]水平明显降低,且观察组明显低于对照组(P<0.05);治疗前两组患者血清CCK-A水平无明显差异(P>0.05),治疗后观察组和对照组患者血清CCK-A水平[121.36±10.47(ng/mg)vs 115.39±10.39(ng/mg)]明显升高,且观察组高于对照组(P<0.05)。结论:依泽替米贝辅助腹腔镜微创术能有效减少胆囊结石患者的结石数量、降低结石直径,并且可以降低患者血清炎性因子水平,促进CCK-A表达,减轻胆囊炎症反应,缓解患者痛苦,有较好的临床效果。

Effect of Ezetimibe-assisted Laparoscopic Minimally Invasive Surgery on Inflammatory Factor and Serum CCK-A Expression in Patients with Cholecystolithiasis

Objective:To investigate the effect of ezetimibe-assisted laparoscopic minimally invasive surgery on inflammatory factors and serum CCK-A expression in patients with gallstones.Methods:100 patients with gallstones admitted to our hospital from February 2016 to February 2018 were divided into control group(laparoscopic minimally invasive surgery)and observation group(laparoscopic minimally invasive surgery+ezetimibe),50 cases in each group.The clinical efficacy,the number and diameter of gallstones,the levels of TNF-α,IL-1 and serum CCK-A were observed and compared before and after treatment.Results:There were 2 cases of infection,1 case of pancreatitis and 3 cases of infection in the observation group and there was no significant difference in complications between the two groups(P<0.05).After operation,the effective rate of the observation group was higher than that of the control group(94.0%vs 58.0%).Before taking medicine,there was no significant difference in the average number and diameter of gallstones between the two groups;after four weeks of treatment,the number of gallstones in the observation group and the control group(5.16±2.35 vs 9.18±2.82)and the diameter of gallstones(0.78±0.29 cm vs 1.26±0.36 cm)in the observation group and the control group were increased and the observation group was higher than the control group.There was no significant difference in the levels of serum TNF-αand IL-1 between observation group and control group before treatment.After four week of treatment,the levels of serum TNF-α(15.28±4.28 ng/mg vs 22.19±5.02 ng/mg)and IL-1(63.38±8.27μg/mg vs 89.59±7.39μg/mg)in the observation group were lower than those in the control group.There was no significant difference in serum CCK-A level between the two groups before treatment;after four week of treatment,the serum CCK-A level of the observation group and the control group increased significantly and the observation group was higher than the control group.Conclusion:Ezetimibe-assisted laparoscopic minimally invasive surgery can effectively reduce the number and diameter of gallstones in patients with gallstones,reduce the level of serum inflammatory factors,promote the expression of CCK-A,alleviate gallbladder inflammation,alleviate the pain of patients,and has a good clinical effect.