国产生长抑素联合前列地尔治疗高脂血症性急性胰腺炎临床观察

目的：探讨国产生长抑素联合前列地尔治疗高脂血症性急性胰腺炎的疗效及安全性。方法选取2012年5月至2015年5月于我院消化内科治疗的120例高脂血症性急性胰腺炎患者，按随机数表法分为对照组和观察组各60例。两组患者均给予常规治疗，对照组患者在此基础上给予前列地尔注射液10μg加生理盐水20 mL静脉注射；观察组患者在对照组治疗的基础上给予注射用国产生长抑素0.25 mg加入5%葡萄糖注射液250 mL中静脉滴注，疗程均为两周。比较两组患者治疗后的血清甘油三脂(TG)、C反应蛋白(CRP)、前白蛋白(PA)、血液流变学、血尿淀粉酶(AMS)指标；记录两组患者腹痛持续时间、腹膜炎体征消失时间、胃肠功能恢复时间、血淀粉酶恢复正常时间及住院时间，比较两组患者的临床疗效、并发症和不良反应发生率。结果观察组患者的治疗总有效率为96.7%(58/60)，明显高于对照组的81.7%(49/60)，差异有统计学意义(P<0.05)；治疗后，观察组患者的血清TG、CRP、PA及各种血液流变学指标均显著优于对照组，差异均有统计学意义(P<0.05)，而血、尿AMS水平与对照组比较差异均无统计学意义(P>0.05)；观察组腹痛持续时间、腹膜炎体征消失时间、胃肠功能恢复时间、血淀粉酶恢复正常时间及住院时间分别为(7.3±4.3) d、(10.3±5.8) d、(4.3±1.1) d、(6.1±5.2) d、(17.4±9.5) d，均明显低于对照组的(9.3±5.3) d、(13.7±6.4) d、(7.1±1.8) d、(7.7±6.0) d、(24.4±10.8) d，差异均有统计学意义(P<0.05)；观察组患者并发症发生率(6.7%)及不良反应发生率(3.3%)均显著低于对照组的30.0%和15.0%，差异均有统计学意义(P<0.05)。结论国产生长抑素联合前列地尔治疗高脂血症性急性胰腺炎疗效显著，其能够显著提高治愈率，缩短病程，且安全性较好。

Clinical observation of domestic somatostatin combined with alprostadil in the treatment of hyperlipidemic acute pancreatitis

Objective To explore the therapeutic efficacy and safety of domestic somatostatin combined with alprostadil in the treatment of hyperlipidemic acute pancreatitis. Methods One hundred and twenty patients with hyper-lipidemic acute pancreatitis treated in the Department of Gastroenterology between May 2012 and May 2015 were ran-domly divided into the control group and the observation group, both with 60 patients. On the basis of routine therapy, the control group was given intravenous dripping of alprostadil for injection 10μg added into normal saline 20 mL once a day, and the observation group was given intravenous dripping of somatostatin for injection 0.25 mg added into 5%glu-cose injection 250 mL once a day. The treatment course of the two groups lasted for 2 weeks. After treatment, serum tri-glyceride (TG), C-reactive protein (CRP), prealbumin (PA), hemorheology, blood and uric amylase (AMS) were com-pared between the two groups. Duration of abdominal pain, the disappearing of peritonitis symptoms, the resumption of gastrointestinal functions, the resumption of blood amylase and length of hospital stay were also recorded in the two groups. The clinical efficacy of the two groups was compared. The incidence of complications and adverse reaction were also observed. Results The total effective rate of the observation group 96.7%(58/60)] was significantly high-er than that of the control group 81.7%(49/60)], and the difference was statistically significant (P<0.05). The levels of TG, CRP, PA and hemorheology of the observation group were significantly better than those of the control group, and the differences were statistically significant (P<0.05). However, there was no difference in the level of blood and uric amylase between the two groups (P>0.05). Duration of abdominal pain, the disappearing of peritonitis symptoms, the resumption of gastrointestinal functions, the resumption of blood amylase and length of hospital stay of the obser-vation group (7.3±4.32) d, (10.3±5.8) d, (4.3±1.1) d, (6.1±5.2) d, (17.4±9.5) d, respectively] were significantly shorter than those of the control group of (9.3±5.3) d, (13.7±6.4) d, (7.1±1.8) d, (7.7±6.0) d, (24.4±10.8) d, with statistically sig-nificant differences (P<0.05). The incidence of complications and adverse reaction of the observation group (6.7%and 3.3%) were significantly lower than those of the control group (30.0%and 15.0%), with statistically significant differenc-es (P<0.05). Conclusion Domestic somatostatin combined with alprostadil has significant effect on hyperlipidemic acute pancreatitis with sound safety.