血必净联合生长抑素在重症急性胰腺炎患者中的疗效观察及对T淋巴细胞水平的影响研究

目的:探讨血必净联合生长抑素在重症急性胰腺炎患者中的临床效果及对T淋巴细胞水平的影响。方法:选择2017年5月～2018年1月入院治疗的重症急性胰腺炎患者100例,两组均给予基础常规方法治疗,根据治疗方案不同分为对照组(n=50)和观察组(n=50)。对照组采用生长抑素治疗,观察组在对照组基础上联合血必净治疗,两组均连续治疗1个月,治疗完毕后对患者效果进行评估。记录并统计两组排气恢复、腹痛消失、血淀粉酶恢复、呼吸机撤离及平均住院时间;采用酶联免疫吸附试验测定两组治疗前、治疗1个月后白细胞介素-6(IL-6)、白细胞介素-10(IL-10)和肿瘤坏死因子-α(TNF-α)水平;采用流式细胞仪测定两组治疗前、治疗1个月后CD3^+、CD4^+、CD8^+及CD4^+/CD8^+水平;记录并统计两组肝肾功能异常、血压升高、皮疹、眩晕发生率,比较两组临床疗效及对T淋巴细胞水平的影响。结果:观察组血必净联合生长抑素治疗1个月后排气恢复、腹痛消失、血淀粉酶恢复、呼吸机撤离及平均住院时间均短于对照组(P<0. 05);观察组治疗1个月后IL-6、TNF-α水平均低于对照组(P<0. 05);观察组治疗1个月后IL-10高于对照组(P<0. 05);观察组治疗1个月后CD3^+、CD4^+及CD4^+/CD8^+水平均高于对照组(P<0. 05);观察组治疗1个月后CD8+水平低于对照组(P<0. 05);观察组治疗1个月后肝肾功能异常、血压升高、皮疹、眩晕发生率与对照组比较差异无统计学意义(P>0. 05)。结论:将血必净联合生长抑素用于重症急性胰腺炎患者中能缩短症状改善时间,降低炎症因子水平,改善患者T淋巴细胞水平,安全性较高,值得推广应用。

Effect of Xuebijing combined with somatostatin on severe acute pancreatitis and its effect on T lymphocyte level

Objective:To investigate the clinical effect of Xuebijing combined with somatostatin in patients with severe acute pancreatitis and its effect on the level of T lymphocytes. Methods: 100 patients with severe acute pancreatitis who were hospitalized from May 2017 to January 2018 were selected.Both groups were given conventional treatment.According to the treatment plan,they were divided into control group ( n =50) and observation group ( n =50).The control group was treated with somatostatin.The observation group was combined with Xuebijing on the basis of the control group.Both groups were treated continuously for one month.After the treatment was completed,the effect of the patient was evaluated.Record and count the two groups of exhaust recovery,abdominal pain disappearance,blood amylase recovery,ventilator evacuation and average length of stay.Use of enzyme-linked immunosorbent assay to determine interleukin-6 (IL-6) Interleukin-10 (IL-10) and tumor necrosis factor-α(TNF-α) levels.CD3^+,CD4^+,CD8^+ and CD4^+/CD8^+ were determined by flow cytometry before and after treatment in both groups.The levels of CD8^+ were recorded and statistics were made on the abnormalities of liver and kidney function,elevated blood pressure,rash and vertigo in both groups.The clinical efficacy and effects on T lymphocyte levels were compared between the two groups. Results: After one month of treatment with Xuebijing and somatostatin in the observation group,the exhaust recovery,abdominal pain disappearance,blood amylase recovery,ventilator evacuation and average length of stay were all shorter than the control group ( P <0.05).The levels of IL-6 and TNF-α at one month after treatment were lower than those in the control group ( P <0.05).IL-10 was higher in the observation group at 1 month after treatment than in the control group ( P <0.05).The levels of CD3^+,CD4^+ and CD4^+/CD8^+ in the first month after transplantation were significantly higher than those in the control group ( P <0.05).The CD8^+ level in the observation group was lower than that in the control group at 1 month after treatment( P <0.05).In the observation group at 1 month after treatment there was no significant difference in the incidence of liver and kidney dysfunction,blood pressure,skin rash and dizziness compared with the control group ( P >0.05). Conclusion: The combination of Xuebijing and somatostatin in patients with severe acute pancreatitis can shorten the time of symptom improvement,reduce the level of inflammatory factors,and improve the level of T lymphocytes in patients with high safety.It is worthy of popularization and application.