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目的研究乌司他丁联合谷氨酰胺治疗急性重症胰腺炎(SAP)的疗效及对血清炎症因子与肝功能的影响。方法选取2014年9月至2016年10月郑州市第三人民医院急性重症胰腺炎患者54例,按照治疗方案不同分组,各27例。对照组予以常规治疗;观察组在对照组基础上予以乌司他丁+谷氨酰胺治疗。统计对比两组临床治疗效果及治疗前后血清炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-a(TNF-α)、超敏-C反应蛋白(hsCRP)]水平、肝功能指标[丙氨酸转氨酶(ALT)、血清肌酐(Scr)、天冬氨酸转氨酶(AST)、血尿素氮(BUN)、总胆红素(TBIL)]水平变化。结果治疗后两组临床治疗有效率比较,观察组(92.59%)明显高于对照组(70.37%),差异有统计学意义(χ2=4.418,P<0.05);治疗后观察组IL-6、hs-CRP、TNF-α水平低于对照组,差异有统计学意义(P<0.05);治疗后观察组ALT、Scr、AST、BUN、TBIL水平低于对照组,差异有统计学意义(P<0.05)。结论乌司他丁联合谷氨酰胺治疗急性重症胰腺炎临床疗效显著,能明显降低炎症因子水平,改善肝功能。
Objective To study the efficacy of ulinastatin combined with glutamine in the treatment of acute severe pancreatitis (SAP) and its effect on serum inflammatory factors and liver function. Methods From September 2014 to October 2016, 54 patients with acute severe pancreatitis in the Third People’s Hospital of Zhengzhou City were selected and divided into groups according to the treatment plan, with 27 cases in each group. The control group was given routine treatment. The observation group was treated with ulinastatin + glutamine on the basis of the control group. The clinical curative effect and the levels of serum inflammatory factors [IL-6, TNF-α, hsCRP], liver function The levels of ALT, Scr, AST, BUN, TBIL were measured. Results After treatment, the effective rate of clinical treatment in the two groups was significantly higher than that in the control group (92.59% vs 70.37%, χ2 = 4.418, P <0.05). After treatment, the levels of IL-6, (P <0.05). After treatment, the levels of ALT, Scr, AST, BUN and TBIL in the observation group were lower than those in the control group (P <0.05), and the difference was statistically significant (P <0.05). Conclusion Ulinastatin combined with glutamine treatment of acute severe acute pancreatitis has a significant clinical effect, can significantly reduce the level of inflammatory cytokines, improve liver function.