乌司他丁治疗重症急性胰腺炎系统性炎症反应综合征的临床研究

目的探讨乌司他丁治疗重症急性胰腺炎的临床价值。方法将84例重症急性胰腺炎患者随机分为试验组（42例）和对照组（42例）。试验组患者在常规治疗的基础上，自入院当天开始连续7d静脉滴注乌司他丁，对照组患者仅予常规治疗。对比两组患者治疗前后血清中炎性介质、肝肾功能变化以及临床疗效。结果治疗7d时，两组患者肿瘤坏死因子-α、白细胞介素（IL）-1、IL-6、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、尿素氮、肌酐比较差异均有统计学意义（P〈0．05或〈0．01）；试验组患者并发症发生率为14．3％（6／42），住院时间为（29．4±1．5）d，器官功能衰竭发生率为28．6％（12／42），均较对照组患者的38．1％（16／42）、（34．4±1．8）d和47．6％（20／42）有明显降低，差异有统计学意义（P〈0．01或〈0．05）。结论乌司他丁能抑制重症急性胰腺炎患者的部分炎性介质的分泌和释放，并保护重要脏器功能，降低并发症，有良好的临床疗效。

Clinical study of ulinastatin on the treatment of systemic infiammtory response syndrome in severe acute pancreatis

Objective To evaluate the clinical value of ulinastatin on the treatment of systemic inflammatory response syndrome in severe acute pancreatitis. Method Eighty-four patients with severe acute pancreatitis were randomly divided into two groups. In the treatment group （42 cases）,on the base of routine treatment, ulinastatin was administered intravenously for seven days after hospitalization, while in the control group only routine treatment was given （42 cases） to. Inflammatory factors in serum, the changed liver function and renal function were measured in two groups before and after the treatment, and the clinical efficacy were observed. Results There was significant difference in the serum level of tumor necrosis factor- α, interleukin-1, interleukin-6, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen and creatinine on the 7th day between two groups （P〈 0.05 or 〈 0.01 ） ,there were significant differences in the incidence of complications, hospitalization time, incidence of multi-organ failure between two groups [ 14.3%（6/42） vs 38.1%（16/42）, （29.4 ± 1.5）d vs （34.4±1.8）d, 28.6%（12/42） vs 47.6%（20/42）, P〈 0.01 or 〈 0.05 ]. Conclusions Ulinastatin can suppress the secretion and release of some inflammatory factors, protect the important viscera functions and reduce the incidence of complications, and it has favorable clinical efficacy.