摘要
目的探究生长抑素联合埃索美拉唑对重症急性胰腺炎患者胃肠功能、肠黏膜屏障及血清炎症因子的影响。方法选取收治的重症急性胰腺炎患者102例,按照随机数字表法均分为对照组和观察组,各51例。2组患者均给予常规基础治疗,对照组在常规治疗的基础上给予生长抑素,观察组在对照组治疗的基础上加用埃索美拉唑,连续治疗7 d。观察治疗前后胃肠功能的恢复情况,采用胰腺Balthazar CT分级评分、急性生理与慢性健康(APACHE)评分评价病情严重程度,检测尿淀粉酶、血清脂肪酶和血清淀粉酶水平,测定肠黏膜屏障功能指标及血清中炎症因子水平变化。结果治疗后,观察组患者胃肠功能恢复情况优于对照组,其排气恢复时间、肠鸣音消失时间、排便恢复时间、腹痛缓解时间、腹胀缓解时间均较对照组显著缩短(P<0.05);Balthazar CT分级评分、APACHE评分、尿淀粉酶、血清脂肪酶、血清淀粉酶水平、内毒素、D-乳酸和二胺氧化酶(DAO)等肠黏膜屏障功能指标及血清中白细胞介素-6(IL-6)、单核细胞趋化因子蛋白-1(MCP-1)和可溶性细胞间黏附分子-1(sICAM-1)等炎症因子水平均较治疗前明显降低(P<0.05),且观察组患者的变化程度更明显(P<0.05)。结论生长抑素联合埃索美拉唑协同作用更利于减轻患者病情,能促进胃肠功能和肠黏膜屏障功能的恢复,缓解机体炎症反应状态。
Objective To explore the clinical effect of somatostatin combined with esomeprazole on gastrointestinal function,intestinal mucosal barrier and serum inflammatory factors in patients with severe acute pancreatitis.Methods 102 patients with severe acute pancreatitis were selected.According to the random number table method,they were divided into control group and observation group with 51 patients in each group.Patients in both groups were treated with conventional basic therapy.Patients in the control group were treated with somatostatin on a conventional basis,while patients in the observation group were treated with esomeprazole on the basis of the control group for 7 d.The recovery of gastrointestinal function was observed before and after treatment.The severity of the disease was evaluated by Balthazar CT grading and APACHE grading score.The levels of urinary amylase,serum lipase and serum amylase were detected.Changes in intestinal mucosal barrier function and the serum levels of inflammatory factors were measured.Results After treatment,the recovery of gastrointestinal function in the observation group was better than that in the control group.The recovery time of exhaust,intestinal rumbling,defecation,abdominal pain and abdominal distension was significantly shorter than that in the control group(P<0.05).Balthazar CT classification score,APACHE score,urinary amylase,lipase,serum amylase level,serum endotoxin,D-lactic acid,diamine oxidase(DAO),serum interleukin-6(IL-6),monocyte chemoattractrant protein-1(MCP-1)and soluble intercellular adhesion molecule-1(sICAM-1)levels were significantly lower than before treatment(P<0.05),and the changes degree were more obvious in the observation group than in the control group(P<0.05).Conclusion The synergistic effect of somatostatin combined with esomeprazole is more conducive to alleviating the disease,promoting the recovery of gastrointestinal function and intestinal mucosal barrier function,and alleviating the inflammatory reaction state of the body.
作者
招鹏
谭学明
李卫东
朱宏岩
ZHAO Peng;TAN Xueming;LI Weidong;ZHU Hongyan(Department of Gastroenterology of Southeast University Affiliated Zhongda Hospital Jiangbei Wards,Nanjing 210044,China;Department of Gastroenterology of Affiliated Hospital of Suzhou University,Suzhou 215000,China)
出处
《西北药学杂志》
CAS
2020年第4期565-569,共5页
Northwest Pharmaceutical Journal
基金
国家自然科学基金青年科学基金项目(编号:81801109)。
关键词
生长抑素
埃索美拉唑
重症急性胰腺炎
胃肠功能
肠黏膜屏障功能
血清炎症因子
somatostatin
esomeprazole
severe acute pancreatitis
gastrointestinal function
intestinal mucosal barrier function
serum inflammatory factor
