还原型谷胱甘肽联合生长抑素在重症急性胰腺炎治疗中的临床研究

摘要

Objective To observe the clinical efficacy of reduced glutathione combined with somatostatin in the treatment of severe acute pancreatitis,and provide reference for the treatment of severe acute pancreatitis (SAP). Methods 52 patients of SAP in our hospital were chosen from August 2010 to August 2013 .They were divided into observation group and control group by random number method.Both groups received routine therapy, observation group received reduced glutathione combined with somatostatin treatment, control group received somatostatin treat-ment.The symptoms and signs recovery time,gastrointestinal function recovery time,time of serum amylase and serum lipase returning to normal level, liver function, inflammatory cytokines, oxidative index, the occurrence of complica-tions,the number of deaths of the two groups were observed and compared.Results The abdominal pain,bloating, gastrointestinal function,serum amylase,lipase recovery time in observation group were significantly shorter than those of control group,there were significant differences between the two groups ( P 0.05).After treatment,the ALT,AST,TB,γ-GT,IL-6,IL-8,CRP,TNF-α,MDA,SOD in observation group were sig-nificantly lower than those of control group,there were significant differences between the two groups (P0.05 ) .Conclusion Reduced glutathione combined with somatostatin is effective for the treatment of SAP,with short symptom recovery time,protective effect on liver function,good anti-inflammatory and an-tioxidant effect,fewer complications,etc.It is worthy of clinical use.%目的观察还原型谷胱甘肽联合生长抑素治疗重症急性胰腺炎的效果，为临床重症急性胰腺炎的治疗提供参考。方法选择2010年8月至2013年8月来我科住院治疗的重症急性胰腺炎患者52例，采用随机数字法平均分为观察组和对照组。在常规治疗基础上，观察组采用还原型谷胱甘肽联合生长抑素进行治疗，对照组使用生长抑素进行治疗。比较两组的症状及体征恢复正常时间、胃肠道功能恢复时间、血清淀粉酶及血清脂肪酶恢复正常时间、肝功能、炎性细胞因子、氧化指标、并发症发生情况、死亡例数。结果观察组腹痛、腹胀、胃肠道功能、血清淀粉酶、脂肪酶恢复正常时间明显短于对照组，差异有统计学意义（ P＜0.05）；体温恢复正常时间略短于对照组，但差异无统计学意义（ P＞0.05）。治疗后，观察组ALT、AST、TB、γ-GT、IL-6、IL-8、CRP、TNF-α、MDA、SOD均明显低于对照组，差异有统计学意义（ P＜0.05）；IL-10、GSH-Px明显高于对照组，差异有统计学意义（ P＜0.05）。观察组呼吸窘迫综合征、肝功能衰竭、胰腺假性囊肿、脓肿发生例数及死亡例数均略低于对照组，差异无统计学意义（ P＞0.05）。结论还原型谷胱甘肽联合生长抑素治疗重症急性胰腺炎具有症状缓解时间短、胃肠道功能恢复快、保护肝功能、抗炎及抗氧化作用强、并发症发生较少等优点，是一种有效的治疗方式，值得临床借鉴使用。