乌司他丁治疗急性胰腺炎的临床疗效及机制研究

目的:探讨乌司他丁对急性胰腺炎患者的临床疗效及可能机制。方法:收集我院收治的重症急性胰腺炎患者66例,随机分为实验组和对照组。所有患者均给予禁食水、充分补液、纠正电解质紊乱等常规支持对症治疗。对照组予奥曲肽,实验组予乌司他丁,共治疗7天。测定两组患者治疗前、后各血清白介素-6(IL-6)、白介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)水平;治疗前、治疗第1、3天及治疗后进行血常规检测,观察白细胞计数(WBC),并进行血淀粉酶(AMS)、尿淀粉酶(UAMY)测定;分别记录两组患者临床症状及体征恢复时间,判定临床疗效。结果:1治疗后,两组患者血清IL-6、IL-8及TNF-α水平均较治疗前显著下降,且实验组较对照组下降更明显(P0.05);2治疗后,两组患者白细胞计数及血、尿淀粉酶水平均较治疗前明显下降,且实验组较对照组下降更明显(P0.05);3治疗后,实验组各项临床症状及体征消失时间均明显短于对照组(P0.05)。结论:乌司他丁可有效改善急性胰腺胰腺炎患者的各项临床症状,这可能与其显著降低其血清IL-6、IL-8、TNF-α、淀粉酶水平、白细胞计数及尿淀粉酶水平有关。

Clinical Effect of Ulinastatin on the Acute Pancreatitis and Its Mechanisms

Objective:To investigate the clinical effect of ulinastatin on the acute pancreatitis and its mechanisms.Methods:66patients with acute pancreatitis from our hospital were selected and randomly divided into the control group and the experimental group.The control group was treated by octreotide and the experimental group was treated by ulinastatin for 7 days. The serum IL-6, IL-8 andTNF-alpha levels were compared before and after treatment. The white blood cell count (WBC), serum amylase (AMS), urine amylaseUAMY levels as well as the recovery time of clinical symptoms and signs, clinical efficacy were compared before treatment, on the 1stand 3rd day after treatment.Results:Compared with before treatment, the serum IL-6, IL-8 and TNF-alpha levels, white blood cell count,blood and urine amylase levels of both groups were significantly decreased after treatment (P<0.05), which were more obviously in theexperimental group (P<0.05). After treatment, the clinical symptoms and signs disappeared in the experimental group were significantlyearlier than the control group (P < 0.05).Conclusion:Ulinastatin could effectively improve the clinical symptoms of acute pancreatitispatients, which might be related to the decrease of serumIL-6, IL-8 and TNF-alpha, white blood cell count, blood and urine amylase levels.