施他宁联合乌司他丁治疗重症急性胰腺炎的疗效及其对免疫功能、sTREM-1和sB7-H2水平的影响

目的探讨施他宁联合乌司他丁治疗重症急性胰腺炎患者的疗效及其对免疫功能、可溶性髓样细胞表达的激发受体-1(Soluble triggering receptor expressed on myeloid cells-1,sTREM-1)和可溶性B7-H2(sB7-H2)水平的影响。方法选取2010年3月至2015年2月我院诊治的96例重症急性胰腺炎患者为研究对象,依据治疗方法的不同,以随机数字表法将患者分为施他宁组(单独组)和施他宁+乌司他丁组(联合组),每组48例。分别比较两组患者的临床疗效、免疫功能、sTREM-1和sB7-H2水平。结果单独组患者的总体治疗有效率为77.08%,略低于联合组的85.42%,两组比较差异无统计学意义(P>0.05)。治疗后,两组患者的sTREM-1和sB7-H2含量显著降低,且两组比较差异有统计学意义(P<0.05)。免疫功能指标检测结果显示,治疗后两组患者CD4~+(%)、CD4~+/CD8~+和IgG含量显著升高,CD8~+(%)和补体C3水平明显下降(P<0.05);联合组患者上述指标的改善优于单独组(P<0.05)。结论尽管施他宁联合乌司他丁不提高重症急性胰腺炎的临床疗效,但能显著改善患者的部分免疫功能,降低sTREM-1和sB7-H2的水平。

Clinical efficacy of stilamin combined with ulinastatin in the treatment of severe a-cute pancreatitis and its effect on immune function and the levels of sTREM-1 and sB7-H2

Objective To investigate the clinical efficacy of stilamin combined with ulinastatin in the treatment of severe acute pancreatitis and its effect on the immune function and the levels of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) and soluble B7-H2 (sB7-H2). Methods Ninety-six cases of severe acute pancreatitis patients from March 2010 to February 2015 in our hospital were selected and randomly divided into stilamin group (single group,n=48) and stilamin+ulinastatin group (combined group,n=48) according to different treatment. The clinical efficacy,immune function and levels of sTREM-1 and sB7-H2 were compared between the two groups. Results The total effective rates of single group and combined group were 77. 08% and 85. 42%,and there was no significant difference between the two groups ( P >0. 05 ) . The contents of sTREM-1 and sB7-H2 decreased significantly after treatment,and there were significant differences between the two groups ( P<0. 05 ) . The results of immune function detections showed that the levels of CD4 +(%) ,CD4 + /CD8 + and IgG increased significantly,while CD8 +(%) and complement C3 decreased markedly ( P<0. 05 ) , and there were significant differences in the above indexes between the two groups (P<0. 05). Conclusion Although stilamin combined with ulinastatin do not improve the clinical effi-cacy in the treatment of severe acute pancreatitis,it can significantly improve the immune function and reduce the levels of sTREM-1 and sB7-H2.