摘要
目的观察奥曲肽联合乌司他丁对急性胰腺炎(AP)患者血液流变学、血清炎症因子及血清可溶性肿瘤坏死因子受体(sTNF-R)水平的影响。方法将AP患者分为对照组与试验组。对照组接受醋酸奥曲肽注射液静脉滴注0.3mg,bid,试验组在对照组治疗的基础上给予注射用乌司他丁1.0×10^(5)U,bid。比较2组患者临床疗效、腹痛缓解时间、首次排便时间、胃肠减压时间及住院时间、血液流变学(全血高切黏度、血浆比黏度、血小板黏附率)、血清炎症因子[C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)]及sTNF-R水平,并进行安全性评价。结果试验组与对照组均纳入40例。治疗后,试验组和对照组的总有效率分别为85.00%(34例/40例)和65.00%(26例/40例),在统计学上差异有统计学意义(P<0.05)。治疗后,试验组与对照组腹痛缓解时间分别为(1.29±0.33)和(1.68±0.45)d,首次排便时间分别为(2.93±0.65)和(3.30±0.72)d,胃肠减压时间分别为(5.96±1.02)和(6.84±1.31)d,住院时间分别为(9.99±1.30)和(11.18±1.97)d,全血高切黏度分别为(5.22±0.25)和(5.61±0.38)mPa·s,血浆比黏度分别为(1.77±0.11)%和(1.84±0.17)%,血小板黏附率分别为(35.10±8.52)%和(42.55±10.01)%,CRP分别为(8.37±1.26)和(18.05±2.20)mg·L^(-1),TNF-α分别为(168.41±22.64)和(183.36±30.77)pg·mL^(-1),IL-2分别为(28.69±4.76)和(40.08±6.74)pg·mL^(-1),IL-6分别为(43.06±11.02)和(50.58±13.67)pg·mL^(-1),IL-8分别为(80.13±22.66)和(94.65±26.05)pg·mL^(-1),sTNF-R分别为(1.12±0.14)和(1.46±0.20)ng·mL^(-1),在统计学上差异均有统计学意义(均P<0.05)。试验组的药物不良反应主要有头晕、恶心呕吐及皮肤过敏,对照组的药物不良反应主要有头晕。试验组和对照组的总药物不良反应发生率分别为7.50%和2.50%,在统计学上差异无统计学意义(P>0.05)。结论奥曲肽联合乌司他丁治疗能有效改善AP患者血液流变学、血清炎症因子及sTNF-R水平。
Objective To observe the effects of octreotide combined with ulinastatin on hemorheology,serum inflammatory factors and serum soluble tumor necrosis factor receptor(sTNF-R)level in patients with acute pancreatitis(AP).Methods Patients with AP were divided into the control group and the treatment group.The control group was treated with intravenous infusion of octreotide acetate injection,0.3 mg each time,bid.On this basis,the treatment group was treated with of ulinastatin injection 1.0×10^(5)U,bid.Clinical effects,the time for abdominal pain relief,time to first bowel movement,time for gastrointestinal decompression,length of hospital stay,hemorheology(whole blood high shear viscosity,plasma specific viscosity and platelet adhesion rate),serum inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-2(IL-2),interleukin-6(IL-6),interleukin-8(IL-8)]and sTNF-R level were compared between the groups.The safety was evaluated.Results There were 40 cases in the treatment group and 40 cases in the control group.After treatment,the total effective rates in the treatment group and the control group were 85.00%(34 cases/40 cases)and65.00%(26 cases/40 cases),and the difference was statistically significant(P<0.05).After treatment,the relief time of abdominal pain in the treatment group and the control group were(1.29±0.33)and(1.68±0.45)d;time of first bowel movement were(2.93±0.65)and(3.30±0.72)d;gastrointestinal decompression time were(5.96±1.02)and(6.84±1.31)d;length of hospital stay were(9.99±1.30)and(11.18±1.97)d;whole blood high shear viscosity were(5.22±0.25)and(5.61±0.38)mPa·s;plasma viscosity were(1.77±0.11)%and(1.84±0.17)%;platelet adhesion rates were(35.10±8.52)%and(42.55±10.01)%;CRP levels were(8.37±1.26)and(18.05±2.20)mg·L-1;TNF-αlevels were(168.41±22.64)and(183.36±30.77)pg·mL^(-1);IL-2 levels were(28.69±4.76)and(40.08±6.74)pg·mL^(-1);IL-6 levels were(43.06±11.02)and(50.58±13.67)pg·mL^(-1);IL-8 levels were(80.13±22.66)and(94.65±26.05)pg·mL^(-1);sTNF-R levels were(1.12±0.14)and(1.46±0.20)ng·mL^(-1).The differences between the control group and the treatment group were statistically significant(all P<0.05).Adverse drug reactions in the treatment group mainly included dizziness,nausea and vomiting,and skin allergies.Adverse drug reactions in the control group mainly included dizziness.The total incidence rates of adverse reactions in the treatment group and the control group were 7.50%and2.50%,without statistically significant difference between the groups(P>0.05).Conclusion The combined treatment of octreotide and ulinastatin can effectively improve hemorheology,serum inflammatory factors and sTNF-R level in patients with AP.
作者
孙瑜婧
SUN Yu-jing(Department of Emergency,Zhongshan Hospital Affiliated to Xiamen University,Xiamen 361004,Fujian Province,China)
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2024年第18期2650-2654,共5页
The Chinese Journal of Clinical Pharmacology
