乌司他丁对重症急性胰腺炎全身炎症反应的抑制作用及对疗效的影响

摘要

Objective To study the inhibition of ulinastatin on systematic inflammation of patients with se‐vere acute pancreatitis .Methods Patients with severe acute pancreatitis were divided into ulinastatin combination therapy group (observation group) and conventional therapy group (control group) .The curative effects , APACHEⅡ score and inflammation factors were compared .Results The pre‐therapy differences of APACHEⅡscore ,hs‐CRP ,TNF‐α,IL‐6 ,IL‐8 and IL‐10 between observation group and control group were not statistically significant .The post‐therapy APACHE Ⅱ score ,hs‐CRP ,TNF‐α,IL‐6 ,IL‐8 decreased in both groups (P<0.05) ,while IL‐10 increased (P<0.05) .The post‐therapy APACHEⅡ score ,hs‐CRP ,TNF‐α,IL‐6 ,IL‐8 in observation group were significantly lower than those in control group (P<0.05) ,while IL‐10 was higher (P<0.05) .Conclusion Ulinastatin could significantly decrease systematic inflammation on patients with severe acute pancreatitis .It can significantly promote the curative effects and decrease mortality .%目的：研究乌司他丁对重症急性胰腺炎全身炎症的抑制作用及对疗效的影响。方法根据治疗方法将重症急性胰腺炎患者分为乌司他丁联合治疗组（观察组）和常规治疗组（对照组），比较2组患者治疗前、后APACHEⅡ评分、疗效和炎症因子的差异。结果观察组和对照组重症急性胰腺炎患者治疗前的 APACHEⅡ评分、高敏C反应蛋白（hs‐CRP）、肿瘤坏死因子（TNF）‐α、白细胞介素（IL）‐6、IL‐8和IL‐10水平差异无统计学意义，治疗后APACHEⅡ评分、hs‐CRP、TNF‐α、IL‐6和IL‐8均显著降低，IL‐10均显著升高；观察组重症急性胰腺炎患者治疗后的APACHEⅡ评分、hs‐CRP、TNF‐α、IL‐6和IL‐8均显著低于对照组（均 P＜0.05），IL‐10显著高于对照组（P＜0.05）。观察组患者病死率低于对照组，但差异无统计学意义（P＞0.05）。结论乌司他丁可显著降低重症急性胰腺炎患者全身炎症反应状态，从而提高治疗疗效，降低病死率。