刘喆

【摘要】 目的：探讨乌司他丁联合生长抑素对急性胰腺炎患者胰腺血流灌注及黏膜保护的影响。方法：选取2018年1月-2020年1月于本院收治入院的急性胰腺炎患者100例作为研究对象，按照随机数字表法将其分为观察组和对照组，每组50例。两组均给予常规治疗，在此基础上对照组给予乌司他丁进行治疗，观察组给予乌司他丁联合生长抑素治疗。比较两组治疗后的临床疗效，治疗前及治疗第7天的胰腺血流指标、肠道黏膜屏障功能、炎症因子以及血清淀粉酶水平。结果：观察组的总有效率为96.00%，高于对照组的82.00%，差异有统计学意义（P<0.05）。治疗后，两组的PS、BV、BF、脂肪酸结合蛋白、二胺氧化酶、D-乳酸、hs-CRP、IL-6、IL-8、TNF-α、血清淀粉酶水平均较治疗前有所改善，且观察组各项指标均优于对照组，差异均有统计学意义（P<0.05）。结论：乌司他丁联合生长抑素治疗急性胰腺炎的效果较好，可有效改善患者的胰腺血流指标、肠道黏膜屏障功能、炎症因子以及血清淀粉酶水平，应用价值较高。

【关键词】 乌司他丁 生长抑素 急性胰腺炎 血流灌注 黏膜保护 血清淀粉酶

[Abstract] Objective： To investigate the effect of Ulinastatin combined with Somatostatin on pancreatic blood perfusion and mucosal protection in patients with acute pancreatitis. Method： A total of 100 patients with acute pancreatitis admitted to our hospital from January 2018 to January 2020 were selected as the research objects， they were divided into observation group and control group according to random number table method， 50 cases in each group. Two groups were given conventional treatment， on this basis， the control group was given Ulinastatin treatment， the observation group was given Ulinastatin combined with Somatostatin treatment. The clinical efficacy， pancreatic blood flow index， intestinal mucosal barrier function， inflammatory factors and serum amylase levels were compared between two groups before and on the 7th day of treatment. Result： The total effective rate of the observation group was 96.00%， which was higher than that of 82.00% in the control group， the difference was statistically significant （P<0.05）. After treatment， the levels of PS， BV， BF， fatty acid binding protein， diamine oxidase， D-lactic acid， hs-CRP， IL-6， IL-8， TNF-α and serum amylase in two groups were improved compared with before treatment， the indexes in the observation group were better than those in the control group， the differences were statistical significance （P<0.05）. Conclusion： Ulinastatin combined with Somatostatin has a good effect in the treatment of acute pancreatitis， which can effectively improve the pancreatic blood flow index， intestinal mucosal barrier function， inflammatory factors and serum amylase level， has high application value.

[Key words] Ulinastatin Somatostatin Acute pancreatitis Blood perfusion Mucosal protection Serum amylase

First-authors address： Fengcheng Hospital of Traditional Chinese Medicine， Fengcheng 118100， China

doi：10.3969/j.issn.1674-4985.2021.06.014

急性胰腺炎是消化系统的一种常见的疾病，也是急腹症的一种，是由多种因素引起的机体胰腺组织自身消化，从而导致患者机体胰腺水肿、出血以及坏死等一系列的炎性损伤[1-2]。常见的病因多为胆道疾病、胰管梗阻、饮酒、高甘油三酯血症等，具有较高的病死率，其临床主要的症状表现为明显的急性腹部剧烈疼痛，部分患者感觉疼痛向背部放射，伴有呕吐、发热等一系列癥状等[3-5]。目前临床均为给予综合性的对症治疗，即寻找并消除病因、控制机体的炎症反应，乌司他丁是一种常用的药物。研究发现，乌司他丁是一种应用较为广泛的蛋白酶抑制剂，可有效抑制水解酶，起到保护器官的作用[6]。且随着对该疾病的深一步认识，有研究指出，乌司他丁联合生长抑素联合治疗的效果较好，其中生长抑素可有效减少胰腺的内外分泌以及胃小肠和胆囊的分泌，降低相关的酶活性，对机体的胰腺细胞具有保护作用[7]。……