陈伦虎　孙雪　赵华　罗寿军　孟庆英　陈小霞

【摘要】 目的：觀察乌司他丁联合奥曲肽对急性胰腺炎患者炎症反应及淀粉酶水平的影响。方法：68例急性胰腺炎患者根据数字表法随机分为两组，两组患者入院后采用常规措施进行治疗，对照组（34例）在常规措施上加用奥曲肽治疗，观察组（34例）在对照组基础上加用乌司他丁治疗，两组患者均治疗7 d。比较两组患者治疗总有效率、临床症状消失时间及住院治疗时间，检测两组患者治疗前后血清肿瘤坏死因子（TNF）-α、白介素（IL）-2、C反应蛋白（CRP）等炎症反应相关指标，以及血、尿淀粉酶表达水平。结果：观察组患者治疗总有效率（91.18%）明显高于对照组（73.53%），差异有统计学意义（P<0.05）;观察组患者腹痛不适、恶心呕吐、腹胀、腹膜刺激征等临床症状消失时间及住院治疗时间较对照组明显短（P<0.05）;两组患者治疗前血清TNF-α、IL-2、CRP等炎症反应相关指标及血尿淀粉酶水平比较差异无统计学意义（P>0.05），治疗后两组患者炎症反应相关指标及血尿淀粉酶水平均明显降低（P<0.05），且观察组治疗后降低较对照组治疗后更为明显（P<0.05）。结论：乌司他丁联合奥曲肽治疗急性胰腺炎患者效果显著，不但可促进临床症状尽快改善，缩短住院治疗时间，还可缓解机体炎症反应，降低血尿淀粉酶水平。

【关键词】 乌司他丁; 奥曲肽; 急性胰腺炎; 炎症反应; 淀粉酶

doi：10.14033/j.cnki.cfmr.2019.14.022 文献标识码 B 文章编号 1674-6805（2019）14-00-03

Effect of Ulinastatin Combined with Octreotide on Inflammatory Response and Amylase Levels of Patients with Acute Pancreatitis/CHEN Lunhu，SUN Xue，ZHAO Hua，et al.//Chinese and Foreign Medical Research，2019，17（14）：-53

【Abstract】 Objective：To observe the effect of Ulinastatin combined with Octreotide on inflammatory response and amylase levels of patients with acute pancreatitis.Method：68 patients with acute pancreatitis were randomly divided into two groups according to the number table method.The two groups were treated with conventional measures after admission.The control group（34 cases） was treated with Octreotide on the basis of the conventional measures，and the observation group（34 cases） was treated with Ulinastatin on the basis of the control group.The total effective rate，clinical symptom disappearance time and hospitalization time of the two groups were compared，and the levels of serum tumor necrosis factor（TNF）-α，interleukin-2，C-reactive protein（CRP） and blood，urine amylase expression levels before and after treatment of the two groups were detected.Result：The total treatment effective rate of the observation group（91.18%） was significantly higher than that of the control group（73.53%），the difference was significant（P<0.05）.The clinical symptoms such as abdominal pain and discomfort，nausea and vomiting，abdominal distension，peritoneal irritation and hospitalization time of the observation group were significantly shorter than those of the control group（P<0.05）.There was no significant difference between the two groups before treatment about the serum TNF-α，IL-2，CRP and blood，urine amylase expression levels（P>0.05）.After treatment，the inflammatory reaction related indicators and blood，urine amylase expression levels of the two groups significantly decreased（P<0.05），and the observation group decreased more significant after treatment than those of the control group after treatment（P<0.05）.Conclusion：The treatment of Ulinastatin combined with Octreotide for patients with acute pancreatitis has a significant therapeutic effect，which can not only promote the clinical symptoms to improve as soon as possible，shorten the hospitalization time，but also alleviate the inflammatory reaction and reduce blood，urine amylase expression levels.

【Key words】 Ulinastatin; Octreotide; Acute pancreatitis; Inflammatory response; Amylase

First-authors address：Peoples Hospital of Yunxi County，Yunxi 442600，China

急性胰腺炎是发生率较高的消化系统急症，患者起病急骤、病情进展迅速、死亡率较高，可出现腹痛腹胀、休克、黄疸等临床症状及体征[1-2]。奥曲肽是一种生长抑素类似物，可有效抑制消化酶的合成和分泌过程[3-4]。乌司他丁则是提取自人尿液中的多肽糖蛋白分子，不但具有广谱酶抑制等药理作用，而且还可明显抑制溶酶体酶的活性功能和大量释放过程[5-6]。目前乌司他丁联合奥曲肽对急性胰腺炎患者炎症反应的相关文献报道较少，因此本研究拟进行观察。

1 资料与方法

1.1 一般资料

选择笔者所在医院消化内科2017年2月-2018年10月住院治疗的68例急性胰腺炎患者作为研究对象，纳入标准：所有患者根据临床症状体征、实验室检查及胰腺影像学检查均已确诊[7]。……